Healthcare Provider Details

I. General information

NPI: 1285201251
Provider Name (Legal Business Name): NORTHBOUND PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/08/2021
Last Update Date: 06/21/2024
Certification Date: 06/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9247 N MERIDIAN ST STE 206
INDIANAPOLIS IN
46260-1824
US

IV. Provider business mailing address

9247 N MERIDIAN ST STE 206
INDIANAPOLIS IN
46260-1824
US

V. Phone/Fax

Practice location:
  • Phone: 317-504-7503
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: NORA FOSTER
Title or Position: CEO
Credential: PT
Phone: 574-309-8972