# CENTRAL INDIANA PHYSICAL MEDICINE & REHAB

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063428217
- **Authorized official:** DR. MIRIAM IBRAHIM MD (PRESIDENT)
- **Authorized official phone:** (765) 213-3024

## Contact information

- **Practice address:** 1107 S TILLOTSON AVE, STE 1, MUNCIE, IN 47304-4517
- **Practice address phone:** (765) 213-3024
- **Practice address fax:** (765) 282-9303
- **Mailing address:** 2001 N GRANVILLE AVE, MUNCIE, IN 47303-2110
- **Mailing address phone:** (765) 213-3238
- **Mailing address fax:** (765) 284-2434

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/31/2006
- **Last updated:** 01/16/2020