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General NPI Number Information
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NPI Number | 1760796478
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Entity Type | Organization
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Legal Business Name | LAFREE PHYSICAL THERAPY, P.C.
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 08/05/2010
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Provider Practice Location Address
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Address Line | 3171 E CENTER STREET EXT
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City | WARSAW
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State | IN
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Zip | 46582-3901
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Country | US
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Telephone | 877-485-3394
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Fax | 574-941-2206
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Provider Business Mailing Address
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Address Line | 3171 E CENTER STREET EXT
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City | WARSAW
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State | IN
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Zip | 46582-3901
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Country | US
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Telephone | 877-485-3394
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Fax | 574-941-2206
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Authorized Official
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Title or Position | OWNER
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Name | JOHN EDWARD LAFREE
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Credential |
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Telephone | 877-485-3394
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 53000121A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 53000121A
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License Number State | IN
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