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Organization

PEDIATRIC THERAPY SPECIALTIES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MELISSA SCHILLING (BUSINESS MANAGER)
(812) 351-1490
Entity
Organization

Contact information

Practice address
675 3RD AVE, JASPER, IN 47546-3602
(812) 351-1490
(812) 301-1329
Mailing address
675 3RD AVE, JASPER, IN 47546-3602
(812) 351-1490
(812) 301-1329

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225X00000X
Occupational Therapist
235Z00000X
Speech-Language Pathologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1023500915
IN
05
1063509032
IN
05
1073131710
IN
05
1164814307
IN
05
1295496503
IN
05
1386945764
IN
05
1528658432
IN
05
1689708497
IN
05
1720411739
IN
05
1750911129
IN
05
1790291391
IN
05
1851029318
IN
05
1942812987
IN
Enumeration date
01/25/2021
Last updated
02/25/2025
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