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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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