Interventional Rehabilitation Of Kentucky, P.S.C

LBN: Interventional Rehabilitation Of Kentucky, P.S.C
Interventional Rehabilitation Of Kentucky, P.S.C is an health care organization with primary practice located at 315 E Broadway Suite 250, Louisville KY 40202-3700. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Pain Medicine, which is considered as the primary health care specialty. Interventional Rehabilitation Of Kentucky, P.S.C can be contacted via phone (502) 589-4765, or through Collis, Ricky Stanley via phone (502) 589-4765.

Contact Information

Primary practice address
315 E Broadway Suite 250 Louisville KY 40202-3700
Phone: (502) 589-4765
Fax: (502) 589-4799
Website:
Map and Directions
Authorized official contact:
Name: Collis, Ricky Stanley Doctor of Medicine (MD)
Phone: (502) 589-4765

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X

Profile Details

NPI number 1275549842
LBN Legal business name Interventional Rehabilitation Of Kentucky, P.S.C
DBA Doing business as
Authorized official Collis, Ricky Stanley Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 1st, 2006
Last updated Jul 28th, 2015 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1275549842 NPPES
Indiana MEDICAID 200279470A
Indiana MEDICAID 1103005
Indiana Other 2322033
Indiana MEDICAID 65943870
Indiana Other 372286700

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