Provider Demographics
NPI:1982393849
Name:ROE PHYSICAL THERAPY AND PERFORMANCE, LLC
Entity Type:Organization
Organization Name:ROE PHYSICAL THERAPY AND PERFORMANCE, LLC
Other - Org Name:BUILT PHYSICAL THERAPY & PERFORMANCE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROE
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT, CSCS
Authorized Official - Phone:219-386-2424
Mailing Address - Street 1:3701 MURVIHILL RD
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:IN
Mailing Address - Zip Code:46383-8326
Mailing Address - Country:US
Mailing Address - Phone:219-386-2424
Mailing Address - Fax:833-936-3518
Practice Address - Street 1:3701 MURVIHILL RD
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383-8326
Practice Address - Country:US
Practice Address - Phone:219-386-2424
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-05-04
Last Update Date:2024-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty