Provider Demographics
NPI:1013096668
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIGENFUS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:901-685-7227
Mailing Address - Street 1:155 DIPLOMAT DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46725-1330
Mailing Address - Country:US
Mailing Address - Phone:260-248-4412
Mailing Address - Fax:260-248-4417
Practice Address - Street 1:155 DIPLOMAT DR STE D
Practice Address - Street 2:
Practice Address - City:COLUMBIA CITY
Practice Address - State:IN
Practice Address - Zip Code:46725-1331
Practice Address - Country:US
Practice Address - Phone:260-248-4412
Practice Address - Fax:260-248-4417
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-03
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000175000OtherOTHER
IN156562Medicare Oscar/Certification