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NPI Code Detail

MEDICARE: LORI BEIDL CHOQUETTE PTA

MEDICARE: LORI BEIDL CHOQUETTE PTA
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
1225200000XPhysical Therapy Assistant06002560AIN

General Provider Information

NPI Number : 1114060563
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORI BEIDL CHOQUETTE PTA
Provider Business Mailing Address
First Line : PO BOX 312
Second Line :
City : POSEYVILLE
State : IN
Zip : 47633-0312
Country : US
Telephone Number : 812-484-9310
Fax Number :
Provider Business Practice Location Address
First Line : 4000 TULIP TREE DR
Second Line :
City : PRINCETON
State : IN
Zip : 47670-2300
Country : US
Telephone Number : 812-387-2938
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/15/2007
Last Update Date : 07/08/2007

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Directions to “ LORI BEIDL CHOQUETTE PTA” Practice Location

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