Basic Information
| Provider Information | |||||||||
| NPI: | 1730588013 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | KILAT | ||||||||
| FirstName: | SHEILA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 124 HAWTHORNE LN | ||||||||
| Address2: | |||||||||
| City: | GREENWOOD | ||||||||
| State: | IN | ||||||||
| PostalCode: | 461429430 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3173329861 | ||||||||
| FaxNumber: | 3178934453 | ||||||||
| Practice Location | |||||||||
| Address1: | 3641 ST. MARY'S ROAD | ||||||||
| Address2: | |||||||||
| City: | WEST TERRE HAUTE | ||||||||
| State: | IN | ||||||||
| PostalCode: | 47885 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8129175618 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/22/2014 | ||||||||
| LastUpdateDate: | 04/12/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/12/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 05009911A | IN | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.