MEDICARE: INDIANA TOTAL THERAPY

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	225X00000X	Occupational Therapist
2	332B00000X	Durable Medical Equipment & Medical Supplies
3	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1568694719
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INDIANA TOTAL THERAPY

Provider Business Mailing Address
First Line	:	2354 RTE 119 HWY S
Second Line	:
City	:	HOMER CITY
State	:	PA
Zip	:	15748-7325
Country	:	US
Telephone Number	:	724-479-2259
Fax Number	:	724-479-2280

Provider Business Practice Location Address
First Line	:	2354 RTE 119 HWY S
Second Line	:
City	:	HOMER CITY
State	:	PA
Zip	:	15748-7325
Country	:	US
Telephone Number	:	724-479-2259
Fax Number	:	724-479-2280

Authorized Official
Title or Position	:	CREDENTIALING ADMIN
Name	:	JONI L MILCHAK
Credential	:
Telephone Number	:	724-357-7271

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	08/06/2019

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Directions to “INDIANA TOTAL THERAPY ” Practice Location

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