Organization
AVON PHYSICAL MEDICINE INC
Active
Other names
Health1st
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY J TOLLE (OWNER/PRESIDENT)
(317) 683-1971
Entity
Organization
Contact information
Practice address
8258 ROCKVILLE RD, INDIANAPOLIS, IN 46214
(317) 429-5400
(317) 429-5401
Mailing address
1420 SADLIER CIRCLE E DRIVE, INDIANAPOLIS, IN 46239
(317) 683-1972
(317) 683-1989
Taxonomy
Speciality
Code
Description
License number
State
204D00000X
Neuromusculoskeletal Medicine & OMM Physician
Primary
—
—
208100000X
Physical Medicine & Rehabilitation Physician
—
—
Other
Enumeration date
03/17/2011
Last updated
03/31/2011
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