Therapeutic Innovations Inc
Organization Active NPI Physical Therapist · Brookston, IN
NPI 1023064805 · NPPES record last updated Jun 6, 2008
Key facts
- NPI
- 1023064805
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapist 225100000X
- License
- 05000581A (IN)
- Legal business name
- THERAPEUTIC INNOVATIONS INC
- Practice address
- 111 W Third St
Brookston, IN 47623-0404 - Phone
- (765) 563-6868
- NPI assigned
- May 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Lenard Miller
- Title
- Vice President
- Phone
- (765) 563-6868
Practitioners 2
-
Lenard Harvey Miller, MS, OTR
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist |
225100000X | 05000581A | IN | Yes |
| Occupational Therapist |
225X00000X | 31000116A | IN | |
| Durable Medical Equipment & Medical Supplies | 332B00000X | 69000280A | IN | |
| Customized Equipment (DME) | 332BC3200X |
Addresses
Primary practice location
111 W Third St
Brookston, IN 47623-0404
Mailing address
111 W Third St
PO Box 404
Brookston, IN 47623-0404
Phone (765) 563-6868
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100262780A | Medicaid | IN | |
| 200326830 | Medicaid | IN | |
| 000000508874 | Other | IN | ANTHEM BLUE CROSS BLUE SHIELD |
| 200715320 | Other | IN | EI GROUP NUMBER |
| 000000281243 | Other | IN | ANTHEM BLUE CROSS BLUE SHIELD |
| 000000511018 | Other | IN | ANTHEM BLUE CROSS BLUE SHIELD |
Other providers in Brookston, IN
- Mackenzie K. Lopp
- Lizabeth Lee Marks-Shepard
- Lenard Harvey Miller
- Dianne Sue Talbot
- Tammy Louise Taylor-Walden
- Wells Yeager Best Co., Inc
All providers in Brookston, IN · Physical Therapist in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 6, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.