Healthcare Provider Details

I. General information

NPI: 1922343490
Provider Name (Legal Business Name): MARY ELIZABETH ESCHE DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/10/2012
Last Update Date: 10/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3701 BELLEMEAD AVE
EVANSVILLE IN
47714
US

IV. Provider business mailing address

11220 COPPERLINE RD E
EVANSVILLE IN
47712-8875
US

V. Phone/Fax

Practice location:
  • Phone: 812-479-1411
  • Fax:
Mailing address:
  • Phone: 812-431-3025
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number070.019492
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: