| NPI | 1326260407 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANN PETERSON GARY Owner, President 765-464-3266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05006593a) |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2020-08-22 |