| NPI | 1407118276 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BLAKE WISEMAN Owner 317-989-3578 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05009661A) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: IN 05009422A) |
| 225X00000X Occupational Therapist (Licence: IN 31005549A) | |
| 235Z00000X Speech-Language Pathologist, (Licence: IN 46002474A) | |
| Enumeration Date | 2012-06-08 |
| Last Update Date | 2014-09-24 |