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Organization

HIGHWAY 30 PHYSICAL THERAPY AND REHABILITATION, LLC

Active
Other names
OSC Physical Therapy, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN J. POMPONI DO, FAAOS (OWNER)
(219) 662-2278
Entity
Organization

Contact information

Practice address
333 W. 89TH AVENUE, SUITE W4, MERRIVILLE, IN 46410-7050
(219) 648-2041
(219) 472-0665
Mailing address
333 W. 89TH AVENUE, SUITE W4, MERRIVILLE, IN 46410-7050
(219) 648-2041
(219) 472-0665

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
261Q00000X
Clinic/Center
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
300027182
IN
Enumeration date
03/26/2019
Last updated
02/22/2022
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