Basic Information
| Provider Information | |||||||||
| NPI: | 1841506771 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HEALTH 1ST PHYISCAL THERAPY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2976 N SCATTERFIELD RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460121585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656438781 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2976 N SCATTERFIELD RD | ||||||||
| Address2: | SUITE 150 | ||||||||
| City: | ANDERSON | ||||||||
| State: | IN | ||||||||
| PostalCode: | 460121585 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7656438781 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/30/2010 | ||||||||
| LastUpdateDate: | 08/30/2010 | ||||||||
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| AuthorizedOfficialLastName: | DUNHAM | ||||||||
| AuthorizedOfficialFirstName: | DAVID | ||||||||
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| AuthorizedOfficialTitleorPosition: | OWNER | ||||||||
| AuthorizedOfficialTelephone: | 7656438781 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | DPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208VP0014X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Pain Medicine | Interventional Pain Medicine | 225100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.