Provider Demographics
NPI: | 1396038568 |
---|---|
Name: | EG REHAB SOLUTIONS,LLC |
Entity Type: | Organization |
Organization Name: | EG REHAB SOLUTIONS,LLC |
Other - Org Name: | INDYPHYSICALTHERAPIST.COM |
Other - Org Type: | Doing Business As |
Authorized Official - Title/Position: | PRESIDENT/OWNER |
Authorized Official - Prefix: | MRS |
Authorized Official - First Name: | EILEEN |
Authorized Official - Middle Name: | APOSTOL |
Authorized Official - Last Name: | BURNS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | PT |
Authorized Official - Phone: | 317-698-2130 |
Mailing Address - Street 1: | 5620 WYNRIDGE CT |
Mailing Address - Street 2: | |
Mailing Address - City: | INDIANAPOLIS |
Mailing Address - State: | IN |
Mailing Address - Zip Code: | 46235-7238 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 317-698-2130 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 5620 WYNRIDGE CT |
Practice Address - Street 2: | |
Practice Address - City: | INDIANAPOLIS |
Practice Address - State: | IN |
Practice Address - Zip Code: | 46235-7238 |
Practice Address - Country: | US |
Practice Address - Phone: | 317-698-2130 |
Practice Address - Fax: | 317-823-0662 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2011-05-22 |
Last Update Date: | 2011-07-08 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
IN | 05003853A | 225100000X, 2251E1200X, 2251E1300X, 2251N0400X, 2251P0200X, 2251X0800X, 225200000X, 225400000X |
IN | 5003853A | 2251G0304X, 251E00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 225400000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Rehabilitation Practitioner | Group - Multi-Specialty | |
No | 225100000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Group - Multi-Specialty | |
No | 2251E1200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Ergonomics | Group - Multi-Specialty |
No | 2251E1300X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Electrophysiology, Clinical | Group - Multi-Specialty |
No | 2251G0304X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Geriatrics | Group - Multi-Specialty |
No | 2251N0400X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Neurology | Group - Multi-Specialty |
No | 2251P0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Pediatrics | Group - Multi-Specialty |
No | 2251X0800X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist | Orthopedic | Group - Multi-Specialty |
No | 225200000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapy Assistant | Group - Multi-Specialty | |
No | 251E00000X | Agencies | Home Health | Group - Multi-Specialty |