Provider Demographics
NPI:1467099101
Name:GOLDEN PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:GOLDEN PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OT
Authorized Official - Prefix:
Authorized Official - First Name:TUSHAR
Authorized Official - Middle Name:
Authorized Official - Last Name:LOTHE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-403-9670
Mailing Address - Street 1:3038 ALDWYCH CT
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-6942
Mailing Address - Country:US
Mailing Address - Phone:317-403-9670
Mailing Address - Fax:317-893-2675
Practice Address - Street 1:5080 N STATE ROAD 135 STE G
Practice Address - Street 2:
Practice Address - City:BARGERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46106-8931
Practice Address - Country:US
Practice Address - Phone:317-403-9670
Practice Address - Fax:317-893-2675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2019-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy