Provider Demographics
NPI:1316083967
Name:BROSKY, TONY (PT)
Entity type:Individual
Prefix:MR
First Name:TONY
Middle Name:
Last Name:BROSKY
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4121 DUTCHMANS LN
Mailing Address - Street 2:SUITE 608
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40207-4707
Mailing Address - Country:US
Mailing Address - Phone:502-896-6686
Mailing Address - Fax:502-897-1829
Practice Address - Street 1:4121 DUTCHMANS LN
Practice Address - Street 2:SUITE 608
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-4707
Practice Address - Country:US
Practice Address - Phone:502-896-6686
Practice Address - Fax:502-897-1829
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY001540225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist