Srinivasan K. Sankaran

Individual provider Active NPI Physical Therapist · Cloverdale, IN

NPI 1396089736 · NPPES record last updated Nov 26, 2012

Key facts

NPI
1396089736
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
05003000A (IN)
Practice address
34 S Main St
Cloverdale, IN 46120-8531
Phone
(765) 795-4260
NPI assigned
Nov 26, 2012
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
05003000AINMDPhysical Therapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 05003000A IN Yes

Addresses

Primary practice location

34 S Main St
Cloverdale, IN 46120-8531

Mailing address

6012 Pine Bluff Dr
Avon, IN 46123-6842

Other providers in Cloverdale, IN

All providers in Cloverdale, IN · Physical Therapist in Indiana

Sources for this page

Verify at the official NPI Registry.