Organization
INDY PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PETE MANZELLI MPT (OWNER/CEO)
(317) 849-3517
Entity
Organization
Contact information
Practice address
831 BROAD RIPPLE AVE, INDIANAPOLIS, IN 46220-1960
(317) 849-3517
(317) 849-6397
Mailing address
PO BOX 50370, INDIANAPOLIS, IN 46250-0370
(317) 849-3517
(317) 849-6397
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000505369
ANTHEM/BCBS
IN
Enumeration date
06/21/2007
Last updated
11/27/2007
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