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Respiratory, Developmental, Rehabilitative and Restorative Service Providers Orthotist

Provider NPI: 1780125880

Provider Information:
Gender: F
Not Sole Proprietor

Practice Location:
6330 E 75TH ST SUITE 126 INDIANAPOLIS, IN 46250-2777 US
Tel: 317-577-2273  Fax: 317-577-2279

Business Mailing Address:
Tel: 260-483-5219  Fax: 260-484-2291

NPI Information:
NPI: 1780125880
Entity Type: Individual


PrimaryCodeCategory/DescriptionStateLicense Number
Y222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifiers:


American Medical Association 2012 taxonomy code information

Code: 222Z00000X





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