MEDICARE: BRANCH AND BODY WELLNESS PHYSICAL THERAPY

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

General Provider Information

NPI Number	:	1679429252
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BRANCH AND BODY WELLNESS PHYSICAL THERAPY

Provider Business Mailing Address
First Line	:	3915 BROADWAY ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2728
Country	:	US
Telephone Number	:	574-532-4727
Fax Number	:

Provider Business Practice Location Address
First Line	:	3915 BROADWAY ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46205-2728
Country	:	US
Telephone Number	:	574-532-4727
Fax Number	:

Authorized Official
Title or Position	:	DOCTOR OF PHYSICAL THERAPY
Name	:	KATHRYN TOWNSHEND GRANT
Credential	:	DPT
Telephone Number	:	574-532-4727

Provider Enumeration Date	:	03/06/2026
Last Update Date	:	03/10/2026

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