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General NPI Number Information
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NPI Number | 1730912536
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Entity Type | Organization
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Legal Business Name | A STEP AHEAD PEDIATRIC THERAPY
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Dates
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Enumeration Date | 08/26/2024
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Last Update Date | 08/26/2024
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Provider Practice Location Address
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Address Line | 420 N STATE ST STE B
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City | NORTH VERNON
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State | IN
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Zip | 47265-1040
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Country | US
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Telephone | 812-314-2378
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Fax | 812-373-7616
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Provider Business Mailing Address
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Address Line | 4610 25TH ST
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City | COLUMBUS
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State | IN
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Zip | 47203-3239
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Country | US
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Telephone | 812-314-2378
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Fax | 812-373-7616
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | JESSICA WAGERS
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Credential |
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Telephone | 812-314-2378
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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 |
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License Number State |
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