Healthcare Provider Details

I. General information

NPI: 1073307484
Provider Name (Legal Business Name): WOVEN PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/09/2025
Last Update Date: 04/09/2025
Certification Date: 04/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 EXECUTIVE DR STE B
LAFAYETTE IN
47905-4863
US

IV. Provider business mailing address

18886 DOONEY CT
NOBLESVILLE IN
46062-7519
US

V. Phone/Fax

Practice location:
  • Phone: 765-714-8272
  • Fax:
Mailing address:
  • Phone:
  • 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: LAURA GRABOWSKI
Title or Position: PHYSICAL THERAPIST
Credential: PT, DPT, WCS
Phone: 765-714-8272