Healthcare Provider Details

I. General information

NPI: 1780726257
Provider Name (Legal Business Name): INDIANA PHYSICAL THERAPY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 01/14/2025
Certification Date: 01/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1913 NORTH WAYNE STREET, SUITE D
ANGOLA IN
46307
US

IV. Provider business mailing address

4251 LAHMEYER ROAD
FORT WAYNE IN
46815
US

V. Phone/Fax

Practice location:
  • Phone: 260-624-2288
  • Fax: 260-624-2286
Mailing address:
  • Phone: 260-432-4700
  • Fax: 260-459-9262

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number StateNULL

VIII. Authorized Official

Name: MR. ANDREW L VOGEL
Title or Position: OWNER
Credential: PT
Phone: 260-824-0522