Healthcare Provider Details
I. General information
NPI: 1992755748
Provider Name (Legal Business Name): MIDWEST HEALTHSTRATEGIES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/11/2006
Last Update Date: 09/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1420 S PILGRIM BLVD
YORKTOWN IN
47396-9250
US
IV. Provider business mailing address
3813 S. MADISON ST
MUNCIE IN
47302-5758
US
V. Phone/Fax
- Phone: 765-759-4068
- Fax: 765-759-4075
- Phone: 765-751-3303
- Fax: 765-751-3353
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QR0400X |
| Taxonomy | Rehabilitation Clinic/Center |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
ROBERT
E.
GILDERSLEEVE
Title or Position: CHAIRMAN OF THE BOARD
Credential:
Phone: 765-747-3365