Healthcare Provider Details

I. General information

NPI: 1003971193
Provider Name (Legal Business Name): SOUTHERN INDIANA RESOURCE SOLUTIONS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/27/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 31ST ST
TELL CITY IN
47586-2690
US

IV. Provider business mailing address

1579 S FOLSOMVILLE RD
BOONVILLE IN
47601-9465
US

V. Phone/Fax

Practice location:
  • Phone: 812-547-2389
  • Fax:
Mailing address:
  • Phone: 812-897-4840
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0700X
TaxonomyHearing and Speech Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: LARRY E WANINGER
Title or Position: CFO
Credential:
Phone: 812-897-4840