Organization
GLENWILLOW PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETH E WATKINS (PRESIDENT)
(317) 345-9687
Entity
Organization
Contact information
Practice address
12720 BENT OAK CT, INDIANAPOLIS, IN 46236-7380
(317) 345-9687
(317) 823-8645
Mailing address
12720 BENT OAK CT, INDIANAPOLIS, IN 46236-7380
(317) 345-9687
(317) 823-8645
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
05006252A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000377434
ANTHEM BCBS
IN
Enumeration date
04/03/2006
Last updated
08/22/2020
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