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General NPI Number Information
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NPI Number | 1578605200
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Entity Type | Organization
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Legal Business Name | ADVANTAGE THERAPY INC
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Dates
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Enumeration Date | 02/12/2007
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Last Update Date | 04/23/2015
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Provider Practice Location Address
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Address Line | 9765 RANDALL DR SUITE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46280-1816
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Country | US
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Telephone | 317-222-1409
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Fax | 317-663-3051
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Provider Business Mailing Address
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Address Line | 9765 RANDALL DR STE A
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City | INDIANAPOLIS
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State | IN
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Zip | 46280-1817
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Country | US
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Telephone | 317-222-1409
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Fax | 317-663-3051
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Authorized Official
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Title or Position | PRESIDENT
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Name | DALE TURNER
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Credential | PT
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Telephone | 317-222-1409
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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 | 05000638A
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License Number State | IN
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