Provider Demographics
NPI:1871927939
Name:LKM REHAB, LLC
Entity type:Organization
Organization Name:LKM REHAB, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:K
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:502-599-2753
Mailing Address - Street 1:PO BOX 22232
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40252-0232
Mailing Address - Country:US
Mailing Address - Phone:502-599-2753
Mailing Address - Fax:502-225-9100
Practice Address - Street 1:4400 EVERSHEAD PL
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40241-5107
Practice Address - Country:US
Practice Address - Phone:502-599-2753
Practice Address - Fax:502-225-9100
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-26
Last Update Date:2013-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYPT-0053702251N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Single Specialty