Provider Demographics
NPI:1396943718
Name:ALLIED THERAPEUTIC LLC
Entity type:Organization
Organization Name:ALLIED THERAPEUTIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MASSAGE THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:219-395-1818
Mailing Address - Street 1:425 SAND CREEK DR
Mailing Address - Street 2:SUITE C
Mailing Address - City:CHESTERTON
Mailing Address - State:IN
Mailing Address - Zip Code:46304-1589
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:425 SAND CREEK DR
Practice Address - Street 2:SUITE C
Practice Address - City:CHESTERTON
Practice Address - State:IN
Practice Address - Zip Code:46304-1589
Practice Address - Country:US
Practice Address - Phone:219-395-1818
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-06
Last Update Date:2007-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty