Healthcare Provider Details

I. General information

NPI: 1881762813
Provider Name (Legal Business Name): DALE TURNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 04/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9765 RANDALL DR SUITE A
INDIANAPOLIS IN
46280-1816
US

IV. Provider business mailing address

9765 RANDALL DR STE A
INDIANAPOLIS IN
46280-1817
US

V. Phone/Fax

Practice location:
  • Phone: 317-222-1409
  • Fax: 317-663-3051
Mailing address:
  • Phone: 317-222-1409
  • Fax: 317-663-3051

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number05000638A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: