Individual
TARA RAMESH PAI
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MSPT
Contact information
Practice address
1100 JOLIET ST, SUITE 205, DYER, IN 46311-1996
(219) 864-3300
(219) 864-2569
Mailing address
1100 JOLIET ST, SUITE 205, DYER, IN 46311-1996
(219) 864-3300
(219) 864-2569
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05008485A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000347257
ANTHEM - APT PLUS
IN
01
—
000000347262
ANTHEM - MBWOUDE
IN
01
—
000000347264
ANTHEM - 1ST AID PLUS
IN
Enumeration date
05/26/2006
Last updated
07/08/2007
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