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General NPI Number Information
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NPI Number | 1467429985
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Entity Type | Individual
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Provider Name | GWEN ANN ESHLEMAN P.T.
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Gender | Female
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Dates
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Enumeration Date | 03/02/2006
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Last Update Date | 02/27/2025
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Provider Practice Location Address
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Address Line | 7424 SHADELAND STATION WAY
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City | INDIANAPOLIS
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State | IN
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Zip | 46256-3925
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Country | US
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Telephone | 317-912-4620
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Fax | 317-912-4621
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Provider Business Mailing Address
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Address Line | 33900 HARPER AVE STE 104
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-4258
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Country | US
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Telephone | 630-296-2223
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 05003526A
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License Number State | IN
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