Basic Information
| Provider Information | |||||||||
| NPI: | 1013462985 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ASSOCIATES IN PEDIATRIC THERAPY, LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1900 MIDLAND TRL | ||||||||
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| City: | SHELBYVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 400658141 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026331007 | ||||||||
| FaxNumber: | 5024370624 | ||||||||
| Practice Location | |||||||||
| Address1: | 3620 PAOLI PIKE | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | FLOYDS KNOBS | ||||||||
| State: | IN | ||||||||
| PostalCode: | 471199787 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5026331007 | ||||||||
| FaxNumber: | 5024370624 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2016 | ||||||||
| LastUpdateDate: | 08/22/2016 | ||||||||
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| AuthorizedOfficialLastName: | SAGESER | ||||||||
| AuthorizedOfficialFirstName: | SCOTT | ||||||||
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| AuthorizedOfficialTitleorPosition: | CFO | ||||||||
| AuthorizedOfficialTelephone: | 5026331007 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225X00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Occupational Therapist |
No ID Information.