Provider Demographics
NPI:1356748354
Name:BEVLI HOLDINGS LLC
Entity type:Organization
Organization Name:BEVLI HOLDINGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RAVINDER
Authorized Official - Middle Name:P
Authorized Official - Last Name:BEVLI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:812-701-0074
Mailing Address - Street 1:301 GREEN RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:IN
Mailing Address - Zip Code:47250-2630
Mailing Address - Country:US
Mailing Address - Phone:812-265-8238
Mailing Address - Fax:812-265-8238
Practice Address - Street 1:703 GREEN RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:IN
Practice Address - Zip Code:47250-2145
Practice Address - Country:US
Practice Address - Phone:812-265-8238
Practice Address - Fax:812-265-8238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-19
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05005717A261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy