Organization
MADDOX REHABILITATION SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KOURTNEY MARIE MADDOX OTR (OWNER)
(317) 945-2557
Entity
Organization
Contact information
Practice address
8338 W CHEROKEE LN, FAIRLAND, IN 46126
(317) 945-2557
Mailing address
8338 W CHEROKEE LN, FAIRLAND, IN 46126-9684
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1568897775
INDIVIDUAL NPI
IN
Enumeration date
05/26/2018
Last updated
07/09/2018
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