| NPI | 1982651451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN JEAN GUM Owner 317-913-0350 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: IN 05001785A) |
| Additional Taxonomies | 2251P0200X Physical Therapist, Pediatrics (Licence: IN 05001785A) |
| 2251X0800X Physical Therapist, Orthopedic (Licence: IN 05001785A) | |
| 2251N0400X Physical Therapist, Neurology (Licence: IN 05001785A) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2020-08-22 |