Provider Demographics
NPI:1508279092
Name:PHYSIOPOINT THERAPY
Entity Type:Organization
Organization Name:PHYSIOPOINT THERAPY
Other - Org Name:PHYSIOPOINT THERAPY & WELLNESS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHANAEL
Authorized Official - Middle Name:D
Authorized Official - Last Name:KLOOSTERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:219-801-7777
Mailing Address - Street 1:1841 E SUMMIT ST
Mailing Address - Street 2:
Mailing Address - City:CROWN POINT
Mailing Address - State:IN
Mailing Address - Zip Code:46307-2768
Mailing Address - Country:US
Mailing Address - Phone:219-801-7777
Mailing Address - Fax:
Practice Address - Street 1:1841 E SUMMIT ST
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-2768
Practice Address - Country:US
Practice Address - Phone:219-801-7777
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-03
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009699A261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy