Basic Information
| Provider Information | |||||||||
| NPI: | 1760607022 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ORENDORF | ||||||||
| FirstName: | ROBERT | ||||||||
| MiddleName: | I | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 718 WATERFORD RD | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402071757 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028955875 | ||||||||
| FaxNumber: | 5028951812 | ||||||||
| Practice Location | |||||||||
| Address1: | 4139 CADILLAC CT | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402131578 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5022385150 | ||||||||
| FaxNumber: | 5022385180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 000686 | KY | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.