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1265703243
ROBERT JOHN REVOLT
LOUISVILLE, KY
NPI
1265703243
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: KY A00571)
Enumeration Date
2012-01-23
Last Update Date
2012-01-23
Business Address
-- ROBERT JOHN REVOLT pta
2200 STONY BROOK DR
LOUISVILLE, KY 40220-4016
Phone number: 502-495-6240
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Mailing Address
-- ROBERT JOHN REVOLT pta
11204 COVENTRY GREENS DR
LOUISVILLE, KY 40241-3409
Phone number: 502-708-1124
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