Provider Demographics
NPI:1427211739
Name:FLORA, VANESSA ANTONIE (DPT)
Entity Type:Individual
Prefix:DR
First Name:VANESSA
Middle Name:ANTONIE
Last Name:FLORA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 W 10TH STREET
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46201
Mailing Address - Country:US
Mailing Address - Phone:317-630-7211
Mailing Address - Fax:
Practice Address - Street 1:1001 W 10TH STREET
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46201
Practice Address - Country:US
Practice Address - Phone:317-630-7211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-07-07
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009596A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist