Healthcare Provider Details

I. General information

NPI: 1942642244
Provider Name (Legal Business Name): HAMILTON THERAPY CONSULTANTS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2013
Last Update Date: 07/27/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

484 E CARMEL DR STE 309
CARMEL IN
46032-2812
US

IV. Provider business mailing address

484 E CARMEL DR STE 309
CARMEL IN
46032-2812
US

V. Phone/Fax

Practice location:
  • Phone: 317-660-1379
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: DANIEL A ANZALDUA
Title or Position: PRESIDENT
Credential: MD
Phone: 317-660-1379