Healthcare Provider Details

I. General information

NPI: 1386744530
Provider Name (Legal Business Name): WHITEWATER VALLEY HEALTH CARE MANAGEMENT AND MARKETING INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 02/14/2023
Certification Date: 02/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

750 CHESTER BLVD
RICHMOND IN
47374-1900
US

IV. Provider business mailing address

750 CHESTER BLVD
RICHMOND IN
47374-1900
US

V. Phone/Fax

Practice location:
  • Phone: 765-939-0820
  • Fax: 765-939-0920
Mailing address:
  • Phone: 765-939-0820
  • Fax: 765-939-0920

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name: AMY CULBERTSON
Title or Position: ADMIN
Credential:
Phone: 795-939-0820