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General NPI Number Information
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NPI Number | 1003006255
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Entity Type | Organization
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Legal Business Name | MANUAL THERAPY ASSOCIATES
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Dates
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Enumeration Date | 07/25/2007
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Last Update Date | 07/25/2007
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Provider Practice Location Address
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Address Line | 13431 OLD MERIDIAN ST SUITE 100
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City | CARMEL
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State | IN
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Zip | 46032-7101
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Country | US
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Telephone | 317-817-9930
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Fax | 317-375-7908
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Provider Business Mailing Address
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Address Line | 13431 OLD MERIDIAN ST SUITE 100
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City | CARMEL
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State | IN
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Zip | 46032-7101
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Country | US
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Telephone | 317-817-9930
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Fax | 317-375-7908
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Authorized Official
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Title or Position | OWNER
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Name | MRS. KATHERINE A BEHRENS
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Credential | PT
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Telephone | 317-817-9930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05005408A
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License Number State | IN
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