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Organization

PREMIERE REHAB, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. CHENIN KAE CHESTNUT OTR/L (MEMBER)
(317) 542-7680
Entity
Organization

Contact information

Practice address
9505 E 59TH ST, SUITE B1, INDIANAPOLIS, IN 46216-1025
(317) 542-7680
(317) 542-7682
Mailing address
9505 E 59TH ST, SUITE B1, INDIANAPOLIS, IN 46216-1025
(317) 542-7680
(317) 542-7682

Taxonomy

Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
IN
261QP2000X
Physical Therapy Clinic/Center
Primary
IN
261QR0400X
Rehabilitation Clinic/Center
31003306A
IN

Other

Enumeration date
06/23/2006
Last updated
09/11/2025
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