Organization
INNOVATIVE THEARPY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENDA M BROWN (PT)
(574) 255-1712
Entity
Organization
Contact information
Practice address
430 W CLEVELAND RD., B23, GRANGER, IN 46530
(574) 243-9640
(574) 243-9640
Mailing address
54658 OAK LEAF CT, MISHAWAKA, IN 46545-1862
(574) 255-1712
(574) 255-4840
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003216
IN
225X00000X
Occupational Therapist
—
—
Other
Enumeration date
02/14/2008
Last updated
02/14/2008
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