Provider Demographics
NPI:1316982788
Name:NELTNER, ROBERT A (PT)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:A
Last Name:NELTNER
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:PO BOX 911148
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40591-1148
Mailing Address - Country:US
Mailing Address - Phone:859-278-2121
Mailing Address - Fax:859-276-2795
Practice Address - Street 1:8109-A ALEXANDRIA PIKE
Practice Address - Street 2:
Practice Address - City:ALEXANDRIA
Practice Address - State:KY
Practice Address - Zip Code:41001
Practice Address - Country:US
Practice Address - Phone:859-635-6500
Practice Address - Fax:859-635-6148
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY002091225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY87020913Medicaid