Organization
PRIORITY REHAB
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BLAKE WISEMAN DPT (OWNER)
(317) 989-3578
Entity
Organization
Contact information
Practice address
890 E 116TH ST, SUITE 142, CARMEL, IN 46032-3475
(317) 989-3578
Mailing address
13426 LOST CREEK LN, CARMEL, IN 46074-5836
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05009422A
IN
225100000X
Physical Therapist
Primary
05009661A
IN
225X00000X
Occupational Therapist
31005549A
IN
235Z00000X
Speech-Language Pathologist
46002474A
IN
Other
Enumeration date
06/08/2012
Last updated
09/24/2014
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