Organization
THERATOT, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANI WOODARD (OWNER)
(317) 694-4056
Entity
Organization
Contact information
Practice address
3875 S HERITAGE CT, NEW PALESTINE, IN 46163-9108
(317) 694-4956
(317) 861-0472
Mailing address
3875 S HERITAGE CT, NEW PALESTINE, IN 46163-9108
(317) 694-4956
(317) 861-0472
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05000560A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200666310
—
IN
05
—
200723400A
—
IN
Enumeration date
04/12/2007
Last updated
04/25/2008
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