Organization
PEDIATRIC SPECIALTY REHAB, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHRISTINA C. MERK P.T. (PRESIDENT)
(502) 608-8475
Entity
Organization
Contact information
Practice address
3106 RIDGEWOOD CT, FLOYDS KNOBS, IN 47119-9435
(502) 608-8475
(812) 923-0620
Mailing address
PO BOX 417, FLOYDS KNOBS, IN 47119-0417
(502) 608-8475
(812) 923-0620
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
05002026A
IN
252Y00000X
Early Intervention Provider Agency
Primary
05002026A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000283356
ANTHEM
IN
Enumeration date
08/28/2009
Last updated
08/28/2009
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