# PEDIATRIC THERAPY OF INDIANA, LLC

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

## Provider details

- **NPI number:** 1952845406
- **Authorized official:** MRS. TYLA HUDON OTR (PRESIDENT/OWNER)
- **Authorized official phone:** (317) 379-1794

## Contact information

- **Practice address:** 9000 S COUNTY ROAD 800 W, DALEVILLE, IN 47334-9420
- **Practice address phone:** (317) 379-1794
- **Practice address fax:** (317) 770-0535
- **Mailing address:** 10653 KESTREL CT, NOBLESVILLE, IN 46060-7537
- **Mailing address phone:** (317) 379-1794
- **Mailing address fax:** (317) 770-0535

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QR0400X | Rehabilitation Clinic/Center | 31001941A | IN | Yes |

## Other

- **Enumeration date:** 12/16/2016
- **Last updated:** 12/16/2016