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General NPI Number Information
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NPI Number | 1497979124
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Entity Type | Organization
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Legal Business Name | THERATOT, INC
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 3875 S HERITAGE CT
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City | NEW PALESTINE
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State | IN
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Zip | 46163-9108
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Country | US
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Telephone | 317-694-4956
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Fax | 317-861-0472
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Provider Business Mailing Address
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Address Line | 3875 S HERITAGE CT
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City | NEW PALESTINE
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State | IN
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Zip | 46163-9108
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Country | US
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Telephone | 317-694-4956
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Fax | 317-861-0472
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Authorized Official
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Title or Position | OWNER
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Name | JANI WOODARD
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Credential |
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Telephone | 317-694-4056
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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 | 05000560A
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License Number State | IN
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