Provider Demographics
NPI:1407860117
Name:STRAWSER, PEGGY A (BS OF PT)
Entity Type:Individual
Prefix:
First Name:PEGGY
Middle Name:A
Last Name:STRAWSER
Suffix:
Gender:F
Credentials:BS OF PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10150 LANTERN RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9706
Mailing Address - Country:US
Mailing Address - Phone:317-806-7803
Mailing Address - Fax:317-806-7804
Practice Address - Street 1:10150 LANTERN RD
Practice Address - Street 2:SUITE 250
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-9706
Practice Address - Country:US
Practice Address - Phone:317-806-7803
Practice Address - Fax:317-806-7804
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002500A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN5138013OtherAETNA GROUP #