Organization
TAI LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEROME A JOHANNES PT,DPT (PRESIDENT)
(812) 972-7724
Entity
Organization
Contact information
Practice address
5140 CHARLESTOWN RD, SUIT 1A, NEW ALBANY, IN 47150-9475
(812) 972-7724
(812) 572-4696
Mailing address
5140 CHARLESTOWN RD, SUIT 1A, NEW ALBANY, IN 47150-9475
(812) 972-7724
(812) 572-4696
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003469A
IN
Other
Enumeration date
01/10/2014
Last updated
01/10/2014
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