Provider Demographics
NPI:1831206960
Name:FOLEY HOME PHYSICAL THERAPY
Entity type:Organization
Organization Name:FOLEY HOME PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER - THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:GRANT
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:FOLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PTA
Authorized Official - Phone:317-535-7080
Mailing Address - Street 1:151 DEBORAH LN
Mailing Address - Street 2:
Mailing Address - City:WHITELAND
Mailing Address - State:IN
Mailing Address - Zip Code:46184-9781
Mailing Address - Country:US
Mailing Address - Phone:317-535-7080
Mailing Address - Fax:
Practice Address - Street 1:151 DEBORAH LN
Practice Address - Street 2:
Practice Address - City:WHITELAND
Practice Address - State:IN
Practice Address - Zip Code:46184-9781
Practice Address - Country:US
Practice Address - Phone:317-535-7080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN06002308A251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health