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General NPI Number Information
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NPI Number | 1558785097
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Entity Type | Organization
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Legal Business Name | INDEPENDENCE HOME THERAPY
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Dates
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Enumeration Date | 02/04/2014
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | 5760 EVANS FARM DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035-8542
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Country | US
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Telephone | 740-706-0686
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Fax | 855-321-1683
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Provider Business Mailing Address
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Address Line | 5760 EVANS FARM DR
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City | LEWIS CENTER
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State | OH
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Zip | 43035-8542
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Country | US
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Telephone | 740-706-0686
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Fax | 855-321-1683
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Authorized Official
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Title or Position | OWNER
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Name | KRISTY OTY
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Credential |
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Telephone | 740-706-0686
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number |
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License Number State | OH
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