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General NPI Number Information
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NPI Number | 1508012733
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Entity Type | Organization
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Legal Business Name | THERA-PLUS P.C.
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Dates
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Enumeration Date | 08/07/2008
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Last Update Date | 08/07/2008
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Provider Practice Location Address
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Address Line | 410 WESTWOOD DR
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City | HARTFORD CITY
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State | IN
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Zip | 47348-8828
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Country | US
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Telephone | 765-348-4489
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Fax | 765-348-9890
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Provider Business Mailing Address
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Address Line | 410 WESTWOOD DR
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City | HARTFORD CITY
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State | IN
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Zip | 47348-8828
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Country | US
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Telephone | 765-348-4489
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Fax | 765-348-9890
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MR. DANIEL E. ASHLEY
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Credential | P.T.
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Telephone | 765-348-4489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 05001672A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 252Y00000X
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Taxonomy Name | Early Intervention Provider Agency
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License Number | 05001672A
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License Number State | IN
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