Healthcare Provider Details

I. General information

NPI: 1285930867
Provider Name (Legal Business Name): GAMA PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2011
Last Update Date: 01/31/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N VENTURA WAY
LAGRANGE IN
46761-4100
US

IV. Provider business mailing address

6615 OXBOW LANE
FORT WAYNE IN
46845
US

V. Phone/Fax

Practice location:
  • Phone: 260-312-2416
  • Fax: 260-497-9088
Mailing address:
  • Phone: 260-312-2416
  • Fax: 260-497-9088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: GIRI ANAND
Title or Position: CEO
Credential: RPT
Phone: 260-312-2416