Provider Demographics
NPI:1093866360
Name:ERGONOMIC HEALTH SOLUTIONS
Entity Type:Organization
Organization Name:ERGONOMIC HEALTH SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:J
Authorized Official - Last Name:COTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MHS, OTR
Authorized Official - Phone:574-256-6704
Mailing Address - Street 1:15423 ROSCOMMON LN
Mailing Address - Street 2:
Mailing Address - City:GRANGER
Mailing Address - State:IN
Mailing Address - Zip Code:46530-6280
Mailing Address - Country:US
Mailing Address - Phone:574-273-0851
Mailing Address - Fax:
Practice Address - Street 1:3640 EDISON LAKES PKWY
Practice Address - Street 2:SUITE B
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-3472
Practice Address - Country:US
Practice Address - Phone:574-256-6704
Practice Address - Fax:574-256-2284
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN31000601A2251E1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomicsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2824963OtherCIGNA