Organization
VICTORY LANE CHILDRENS REHAB, LLC
Active
Organization
VICTORY LANE CHILDRENS REHAB, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRETT CHARLES FISCHER MPT (OWNER)
(765) 593-9355
Entity
Organization
Contact information
Practice address
2021 S MEMORIAL DR, NEW CASTLE, IN 47362-1221
(765) 593-9355
Mailing address
2021 S MEMORIAL DR, NEW CASTLE, IN 47362-1221
(765) 593-9355
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
—
—
225100000X
Physical Therapist
—
—
2251E1300X
Clinical Electrophysiology Physical Therapist
—
—
2251P0200X
Pediatric Physical Therapist
Primary
—
—
2251S0007X
Sports Physical Therapist
—
—
225200000X
Physical Therapy Assistant
—
—
225800000X
Recreation Therapist
—
—
225X00000X
Occupational Therapist
—
—
225XF0002X
Feeding, Eating & Swallowing Occupational Therapist
—
—
225XP0200X
Pediatric Occupational Therapist
—
—
235Z00000X
Speech-Language Pathologist
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/04/2012
Last updated
06/04/2012
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