Provider Demographics
NPI:1689846560
Name:APEX THERAPY CLINIC, PC
Entity Type:Organization
Organization Name:APEX THERAPY CLINIC, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHI
Authorized Official - Middle Name:
Authorized Official - Last Name:GASAWAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:317-577-1990
Mailing Address - Street 1:6905 E 96TH ST
Mailing Address - Street 2:SUITE 600
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46250-4453
Mailing Address - Country:US
Mailing Address - Phone:317-577-1990
Mailing Address - Fax:317-577-1993
Practice Address - Street 1:6905 E 96TH ST
Practice Address - Street 2:SUITE 600
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-4453
Practice Address - Country:US
Practice Address - Phone:317-577-1990
Practice Address - Fax:317-577-1993
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-31
Last Update Date:2013-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002002A111NS0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111NS0005XChiropractic ProvidersChiropractorSports PhysicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN232810Medicare PIN