| NPI | 1427270768 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELVIRA ALEXANDRA WARREN President 765-661-4056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: IN 5501012245) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy (Licence: IN 05003874A) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine | |
| 2081P0010X Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine | |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-09-17 |