Provider Demographics
NPI:1366791402
Name:COLLEY, WENDY ROBBINS (DPT)
Entity type:Individual
Prefix:DR
First Name:WENDY
Middle Name:ROBBINS
Last Name:COLLEY
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9312 ALEX CT
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40299-1199
Mailing Address - Country:US
Mailing Address - Phone:502-314-3453
Mailing Address - Fax:
Practice Address - Street 1:9312 ALEX CT
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40299-1199
Practice Address - Country:US
Practice Address - Phone:502-314-3453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-05
Last Update Date:2012-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3844225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist