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General NPI Number Information
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NPI Number | 1972851566
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Entity Type | Organization
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Legal Business Name | BREATHING SPACE, INC
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 08/29/2012
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Provider Practice Location Address
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Address Line | 8627 BLUE MARLIN DRIVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46239
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Country | US
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Telephone | 812-343-4898
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Fax |
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Provider Business Mailing Address
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Address Line | 8627 BLUE MARLIN DRIVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46239
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JULIE PERRY
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Credential |
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Telephone | 812-343-4898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QS1200X
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Taxonomy Name | Sleep Disorder Diagnostic Clinic/Center
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License Number |
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License Number State |
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