Organization
PEDIATRIC PHYSICAL THERAPY SERVICES INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JAMIE STORMONT-SMITH (PRESIDENT OWNER)
(765) 448-1758
Entity
Organization
Contact information
Practice address
80 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 448-1758
(765) 448-3898
Mailing address
80 PROFESSIONAL CT, LAFAYETTE, IN 47905-5152
(765) 448-1758
(765) 448-3898
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200070900A
—
IN
Enumeration date
05/28/2008
Last updated
05/28/2008
Update your record
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