Organization
LAFREE ORTHOPEDIC & SPORTS PHYSICAL THERAPY PC
Active
Organization
LAFREE ORTHOPEDIC & SPORTS PHYSICAL THERAPY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN EDWARD LAFREE PT ATC (OWNER/PHYSICAL THERAPIST)
(574) 941-2200
Entity
Organization
Contact information
Practice address
2934 MILLER DR, PLYMOUTH, IN 46563-8083
(574) 941-2200
(574) 941-2206
Mailing address
2934 MILLER DR, PLYMOUTH, IN 46563-8083
(574) 941-2200
(574) 941-2206
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05004435A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000215756
ANTHEM PROVIDER NUMBER
IN
Enumeration date
07/21/2005
Last updated
06/21/2013
Update your record
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