Provider Demographics
NPI:1245481407
Name:CUTTING EDGE PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:CUTTING EDGE PHYSICAL THERAPY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP, AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:JANNA
Authorized Official - Middle Name:P
Authorized Official - Last Name:KING
Authorized Official - Suffix:
Authorized Official - Credentials:JD
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:512 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:CONNERSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47331-2502
Mailing Address - Country:US
Mailing Address - Phone:765-825-1768
Mailing Address - Fax:765-825-1816
Practice Address - Street 1:512 W 30TH ST
Practice Address - Street 2:
Practice Address - City:CONNERSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47331-2502
Practice Address - Country:US
Practice Address - Phone:765-825-1768
Practice Address - Fax:765-825-1816
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CUTTING EDGE PHYSICAL THERAPY LIMITED PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-10-07
Last Update Date:2009-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN6144560001Medicare NSC