Healthcare Provider Details

I. General information

NPI: 1043828031
Provider Name (Legal Business Name): CONCIERGE HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/16/2020
Last Update Date: 07/16/2020
Certification Date: 07/16/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4847 PLAZA EAST BLVD
EVANSVILLE IN
47715-2811
US

IV. Provider business mailing address

10201 ADMIRAL DR
EVANSVILLE IN
47725-1358
US

V. Phone/Fax

Practice location:
  • Phone: 812-477-4444
  • Fax:
Mailing address:
  • Phone: 812-453-5773
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: DR. BOBBI J PRESTON
Title or Position: CO-OWNER
Credential: DPT
Phone: 812-453-5773