| NPI | 1396814828 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW T. HAVERSTOCK Manager 219-229-0322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251P0200X Physical Therapist, Pediatrics |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05006226A) |
| 235Z00000X Speech-Language Pathologist, (Licence: IN 22004096A) | |
| 225100000X Physical Therapist (Licence: IL 70012822) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IL 146009098) | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 225XP0200X Occupational Therapist, Pediatrics | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 2251P0200X Physical Therapist, Pediatrics | |
| 103K00000X Behavior Analyst (Licence: IN 17030805) | |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2017-04-13 |