MEDICARE: MR. ROBERT HAAN P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	05006800A	IN

General Provider Information

NPI Number	:	1073842449
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROBERT HAAN P.T.

Provider Business Mailing Address
First Line	:	9101 WESLEYAN RD STE 100
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3103
Country	:	US
Telephone Number	:	317-884-3383
Fax Number	:	317-884-3388

Provider Business Practice Location Address
First Line	:	9101 WESLEYAN RD STE 100
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-3103
Country	:	US
Telephone Number	:	800-603-6046
Fax Number	:	317-884-3388

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2009
Last Update Date	:	06/05/2019

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