=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679429252
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | BRANCH AND BODY WELLNESS PHYSICAL THERAPY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/06/2026
-----------------------------------------------------
Last Update Date | 03/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3915 BROADWAY ST
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46205-2728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-532-4727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3915 BROADWAY ST
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46205-2728
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 574-532-4727
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | DOCTOR OF PHYSICAL THERAPY
-----------------------------------------------------
Name | KATHRYN TOWNSHEND GRANT
-----------------------------------------------------
Credential | DPT
-----------------------------------------------------
Telephone | 574-532-4727
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------