Healthcare Provider Details

I. General information

NPI: 1548870397
Provider Name (Legal Business Name): NRG PHYSIOTHERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/06/2020
Last Update Date: 08/31/2020
Certification Date: 08/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2366 SMITH RD
PLAINFIELD IN
46168-6782
US

IV. Provider business mailing address

2366 SMITH RD
PLAINFIELD IN
46168-6782
US

V. Phone/Fax

Practice location:
  • Phone: 903-413-8117
  • Fax:
Mailing address:
  • Phone: 903-413-8117
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VII. Legacy identifiers

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

VIII. Authorized Official

Name: DR. CHAD NOWLIN
Title or Position: OWNER, DPT
Credential: DPT
Phone: 903-413-8117