MEDICARE: HELEN HATFIELD

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	225200000X	Physical Therapy Assistant	06005197A	IN

General Provider Information

NPI Number	:	1912358003
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HELEN HATFIELD

Provider Business Mailing Address
First Line	:	502 N BEND RD
Second Line	:
City	:	BEECH GROVE
State	:	IN
Zip	:	46107-2519
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	502 N BEND RD
Second Line	:
City	:	BEECH GROVE
State	:	IN
Zip	:	46107-2519
Country	:	US
Telephone Number	:	812-592-1347
Fax Number	:

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

Provider Enumeration Date	:	06/29/2016
Last Update Date	:	06/29/2016

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