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General NPI Number Information
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NPI Number | 1942449699
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Entity Type | Organization
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Legal Business Name | INDIANA FITNESS WORKS INC
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 9190 PRIORITY WAY WEST DR STE 110
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1437
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Country | US
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Telephone | 317-805-4963
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Fax | 317-818-0720
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Provider Business Mailing Address
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Address Line | 9190 PRIORITY WAY WEST DR STE 110
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City | INDIANAPOLIS
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State | IN
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Zip | 46240-1437
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Country | US
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Telephone | 317-805-4963
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Fax | 317-818-0720
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. SUZANNE PATTERSON-REED
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Credential | M.S. CCC/SLP
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Telephone | 317-805-4963
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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 |
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License Number State |
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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 |
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License Number State |
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