Organization
PEDIATRIC THERAPY OF INDIANA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TYLA HUDON OTR (PRESIDENT/OWNER)
(317) 379-1794
Entity
Organization
Contact information
Practice address
9000 S COUNTY ROAD 800 W, DALEVILLE, IN 47334-9420
(317) 379-1794
(317) 770-0535
Mailing address
10653 KESTREL CT, NOBLESVILLE, IN 46060-7537
(317) 379-1794
(317) 770-0535
Taxonomy
Speciality
Code
Description
License number
State
261QR0400X
Rehabilitation Clinic/Center
Primary
31001941A
IN
Other
Enumeration date
12/16/2016
Last updated
12/16/2016
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