MEDICARE: TORY MASTERS

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
1	222Q00000X	Developmental Therapist

General Provider Information

NPI Number	:	1932811189
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TORY MASTERS

Provider Business Mailing Address
First Line	:	2163 E 750 N
Second Line	:
City	:	RIDGEVILLE
State	:	IN
Zip	:	47380-9106
Country	:	US
Telephone Number	:	765-644-0500
Fax Number	:

Provider Business Practice Location Address
First Line	:	2163 E 750 N
Second Line	:
City	:	RIDGEVILLE
State	:	IN
Zip	:	47380-9106
Country	:	US
Telephone Number	:	765-644-0500
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/20/2022
Last Update Date	:	12/20/2022

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Directions to “ TORY MASTERS ” Practice Location

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