Provider Demographics
NPI:1508526211
Name:VALIANT PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:VALIANT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BROOKS
Authorized Official - Middle Name:ADAM
Authorized Official - Last Name:HOFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:765-265-5653
Mailing Address - Street 1:11083 CLOVER DR
Mailing Address - Street 2:
Mailing Address - City:BROOKVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47012-8516
Mailing Address - Country:US
Mailing Address - Phone:765-580-2725
Mailing Address - Fax:765-230-5003
Practice Address - Street 1:11083 CLOVER DR
Practice Address - Street 2:
Practice Address - City:BROOKVILLE
Practice Address - State:IN
Practice Address - Zip Code:47012-8516
Practice Address - Country:US
Practice Address - Phone:765-580-2725
Practice Address - Fax:765-230-5003
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-12-21
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty