Organization
PHYSIOTHERAPY ASSOCIATES INC
Active
Other names
Physiotherapy Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAYNE FLECK POOL (CHIEF COMPLIANCE OFFICER)
(469) 467-8705
Entity
Organization
Contact information
Practice address
1234 E DUPONT RD, #7, FORT WAYNE, IN 46825-1545
(260) 490-0940
(260) 490-5063
Mailing address
665 PHILADELPHIA ST, INDIANA, PA 15701-3941
(724) 465-3496
(215) 413-4682
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000175000
BLUE CROSS BLUE SHEILD
IN
05
—
100133720W
—
IN
Enumeration date
02/28/2007
Last updated
06/18/2009
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