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Organization

SPORT ORTHOPEDIC REHABILITATIVE SERVICES INCORPORATED

Active
Other names
Sport Orthopedic Rehab, Sport Orthopedic Rehabilitations
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JAMES E DYE DPT, PT, CSTS (PHYSICAL THERAPIST)
(219) 981-8109
Entity
Organization

Contact information

Practice address
1921 W 25TH AVE UNIT 4, GARY, IN 46404-3548
(219) 981-8109
(219) 980-8168
Mailing address
1921 W 25TH AVE UNIT 4, GARY, IN 46404-3548
(219) 981-8109
(219) 980-8168

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
05002712A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000241485
BC/BS
IN
01
199590
MEDICARE
IN
05
200400020A
IN
Enumeration date
08/04/2009
Last updated
10/13/2025
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