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General NPI Number Information
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NPI Number | 1295772689
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Entity Type | Organization
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Legal Business Name | CHILDREN'S THERAPY PLUS, INC.
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Dates
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Enumeration Date | 06/02/2006
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Last Update Date | 08/27/2009
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Provider Practice Location Address
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Address Line | 6504 E 129TH AVE
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City | CROWN POINT
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State | IN
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Zip | 46307-9087
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Country | US
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Telephone | 219-662-7654
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Fax | 219-662-2136
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Provider Business Mailing Address
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Address Line | 6504 E 129TH AVE
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City | CROWN POINT
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State | IN
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Zip | 46307-9087
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Country | US
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Telephone | 219-662-7654
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Fax | 219-662-2136
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Authorized Official
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Title or Position | OWNER
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Name | MR. ANTHONY MITCHELL CLARK
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Credential |
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Telephone | 219-662-7654
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | IN
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