Healthcare Provider Details

I. General information

NPI: 1689846560
Provider Name (Legal Business Name): APEX THERAPY CLINIC, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/31/2008
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6905 E 96TH ST SUITE 600
INDIANAPOLIS IN
46250-4453
US

IV. Provider business mailing address

6905 E 96TH ST SUITE 600
INDIANAPOLIS IN
46250-4453
US

V. Phone/Fax

Practice location:
  • Phone: 317-577-1990
  • Fax: 317-577-1993
Mailing address:
  • Phone: 317-577-1990
  • Fax: 317-577-1993

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number08002002A
License Number StateIN

VIII. Authorized Official

Name: KATHI GASAWAY
Title or Position: OFFICE MANAGER
Credential:
Phone: 317-577-1990