| NPI | 1508089590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE RIESER Member Manager 317-847-8217 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05006221A) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2020-08-22 |