Gordana Gorgijovski, PTA
Individual provider Active NPI Physical Therapy Assistant · Lowell, IN
NPI 1104166818 · NPPES record last updated Feb 18, 2013
Key facts
- NPI
- 1104166818
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 06004406A (IN)
- Practice address
- 17203 Oak Valley Dr
Lowell, IN 46356-1199 - Phone
- (219) 384-6746
- NPI assigned
- Feb 18, 2013
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 160.006017 | IL | MD | Physical Therapy Assistant |
| 06004406A | IN | MD | Physical Therapy Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 06004406A | IN | Yes |
| Physical Therapy Assistant | 225200000X | 160.006017 | IL |
Addresses
Primary practice location
17203 Oak Valley Dr
Lowell, IN 46356-1199
Mailing address
17203 Oak Valley Dr
Lowell, IN 46356-1199
Phone (219) 384-6746
Other providers in Lowell, IN
- Christian James Gabrano
- Alejandra Garcia
- Angela Jean Gard
- Alexis Geary
- Jessica Goodman
- Diana Lynn Greenberg
- Hancock Regional Hospital
- Jeanine Marie Harley
- Heartland Behavioral Health Inc
- Heartland Recovery Center, Inc.
All providers in Lowell, IN · Physical Therapy Assistant in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2013. 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.