Healthcare Provider Details

I. General information

NPI: 1316102320
Provider Name (Legal Business Name): MILESTONES PEDIATRIC THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2008
Last Update Date: 07/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5749 E COUNTY ROAD 350 S
PLAINFIELD IN
46168-8343
US

IV. Provider business mailing address

5749 E COUNTY ROAD 350 S
PLAINFIELD IN
46168-8343
US

V. Phone/Fax

Practice location:
  • Phone: 317-402-5501
  • Fax:
Mailing address:
  • Phone: 317-402-5501
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number05008130A
License Number StateIN

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: KAREN CRAVOTTA
Title or Position: OWNER
Credential: PT
Phone: 317-402-5501