Provider Demographics
NPI:1952440190
Name:PHYSICAL THERAPY RESOURCES,PC
Entity Type:Organization
Organization Name:PHYSICAL THERAPY RESOURCES,PC
Other - Org Name:TERESA A. MITCHELL, P.T.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:TERESA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:MITCHELL
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:812-479-3099
Mailing Address - Street 1:701 N WEINBACH AVE STE 310
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47711-5990
Mailing Address - Country:US
Mailing Address - Phone:812-479-3099
Mailing Address - Fax:812-479-3099
Practice Address - Street 1:701 N WEINBACH AVE STE 310
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47711-5990
Practice Address - Country:US
Practice Address - Phone:812-479-3099
Practice Address - Fax:812-479-3099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05001914A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000090420OtherANTHEM
IN533120Medicare ID - Type UnspecifiedMEDICARE