Allied Physicians of Michiana, LLC

Organization Active NPI Physical Therapist · South Bend, IN

NPI 1265714778 · NPPES record last updated Mar 17, 2018

Key facts

NPI
1265714778
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapist 225100000X
Legal business name
ALLIED PHYSICIANS OF MICHIANA, LLC
Practice address
6301 University Commons
Suite 430
South Bend, IN 46635-1571
Phone
(574) 968-2851
Fax
(574) 968-2855
NPI assigned
Sep 12, 2011
Organization subpart
Yes
Parent organization (as reported)
ALLIED PHYSICIANS OF MICHIANA, LLC

Authorized official

Name
Shery Roussarie
Title
Ceo
Phone
(574) 251-2100

National Provider Directory

Part of
Allied Physicians of Michiana LLC

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X Yes
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X

Addresses

Primary practice location

6301 University Commons
Suite 430
South Bend, IN 46635-1571

Mailing address

6301 University Commons
Suite 230
South Bend, IN 46635-1571
Phone (574) 251-2100

Other practice location 1

500 Arcade Ave Ste 320
Elkhart, IN 46514-2477
Phone (574) 968-2851

Other identifiers

IdentifierTypeStateIssuer
201048070AMedicaidIN

Other providers in South Bend, IN

All providers in South Bend, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.