Provider Demographics
NPI:1376769448
Name:GEULEN JR., JAMES TAN (RPT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:TAN
Last Name:GEULEN JR.
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1680 SAPPHIRE CT
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:IN
Mailing Address - Zip Code:46342-6543
Mailing Address - Country:US
Mailing Address - Phone:219-945-0513
Mailing Address - Fax:219-945-0513
Practice Address - Street 1:2350 TAFT ST
Practice Address - Street 2:
Practice Address - City:GARY
Practice Address - State:IN
Practice Address - Zip Code:46404-3349
Practice Address - Country:US
Practice Address - Phone:219-977-2600
Practice Address - Fax:219-977-2602
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05007751A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist