Provider Demographics
NPI:1003410507
Name:OPPORTUNITY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:OPPORTUNITY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SALINAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:574-276-4906
Mailing Address - Street 1:17018 FLINCHUM WAY W
Mailing Address - Street 2:
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46062-7126
Mailing Address - Country:US
Mailing Address - Phone:574-276-4906
Mailing Address - Fax:
Practice Address - Street 1:17018 FLINCHUM WAY W
Practice Address - Street 2:
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46062-7126
Practice Address - Country:US
Practice Address - Phone:574-276-4906
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy