Provider Demographics
NPI:1134859176
Name:RIGHT PATH PHYSICAL THERAPY AND PERFORMANCE ACADEMY LLC
Entity type:Organization
Organization Name:RIGHT PATH PHYSICAL THERAPY AND PERFORMANCE ACADEMY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABBEE
Authorized Official - Middle Name:RANAE
Authorized Official - Last Name:SUMMERS
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:765-432-3066
Mailing Address - Street 1:7528 E 300 S
Mailing Address - Street 2:
Mailing Address - City:KOKOMO
Mailing Address - State:IN
Mailing Address - Zip Code:46902-9395
Mailing Address - Country:US
Mailing Address - Phone:765-432-3066
Mailing Address - Fax:
Practice Address - Street 1:1558 E BOULEVARD STE E
Practice Address - Street 2:
Practice Address - City:KOKOMO
Practice Address - State:IN
Practice Address - Zip Code:46902-2587
Practice Address - Country:US
Practice Address - Phone:765-432-3066
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy