Organization
CHAMPION PHYSICAL THERAPY AND FITNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS P. WYNEKEN PT (PRESIDENT/SECRETARY)
(317) 797-4797
Entity
Organization
Contact information
Practice address
65 E GARNER RD STE 100, BROWNSBURG, IN 46112-7867
(317) 797-4797
Mailing address
496 COBBLESTONE PL, AVON, IN 46123-9422
(317) 797-4797
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
05006312A
IN
Other
Enumeration date
10/30/2007
Last updated
10/30/2007
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