MEDICARE: THERAPEUTIC TOUCH FOR INFANTS & CHILDREN, PC

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	2251P0200X	Pediatric Physical Therapist	05002030A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000215001	OTHER	IN	ANTHEM BC/BS IN NETWORK

General Provider Information

NPI Number	:	1982607495
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THERAPEUTIC TOUCH FOR INFANTS & CHILDREN, PC

Provider Business Mailing Address
First Line	:	12623 E 86TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-8548
Country	:	US
Telephone Number	:	317-201-3754
Fax Number	:	317-823-6484

Provider Business Practice Location Address
First Line	:	12623 E 86TH ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46236-8548
Country	:	US
Telephone Number	:	317-201-3754
Fax Number	:	317-823-6484

Authorized Official
Title or Position	:	PHYSICAL THERAPIST/PRESIDENT
Name	:	SHARON C DIETZ
Credential	:	RPT
Telephone Number	:	317-201-3754

Provider Enumeration Date	:	05/30/2005
Last Update Date	:	08/22/2020

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