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NPI Code Detail

MEDICARE: CHILDREN'S THERAPY CONNECTION, INC.

MEDICARE: CHILDREN'S THERAPY CONNECTION, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1252Y00000XEarly Intervention Provider Agency
2225100000XPhysical Therapist

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366609166
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHILDREN'S THERAPY CONNECTION, INC.
Provider Business Mailing Address
First Line : 7209 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2021
Country : US
Telephone Number : 317-288-7606
Fax Number :
Provider Business Practice Location Address
First Line : 7209 N SHADELAND AVE
Second Line :
City : INDIANAPOLIS
State : IN
Zip : 46250-2021
Country : US
Telephone Number : 317-288-7606
Fax Number : 317-288-7607
Authorized Official
Title or Position : PRESIDENT
Name : MR. JASON BERTY
Credential : PT, CSCS
Telephone Number : 317-288-7606
Provider Enumeration Date : 05/20/2008
Last Update Date : 11/11/2022

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Directions to “CHILDREN'S THERAPY CONNECTION, INC. ” Practice Location

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