Provider Demographics
NPI:1396267969
Name:ORDAS, TEODORA MANLANGIT (RPT)
Entity type:Individual
Prefix:MRS
First Name:TEODORA
Middle Name:MANLANGIT
Last Name:ORDAS
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:MISS
Other - First Name:TEODORA
Other - Middle Name:MANLANGIT
Other - Last Name:ATIENZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPT
Mailing Address - Street 1:1201 S SMITH DR
Mailing Address - Street 2:
Mailing Address - City:RUSHVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46173-7127
Mailing Address - Country:US
Mailing Address - Phone:765-561-2956
Mailing Address - Fax:
Practice Address - Street 1:1201 SMITH DRIVE
Practice Address - Street 2:
Practice Address - City:RUSHVILLE
Practice Address - State:IN
Practice Address - Zip Code:46173
Practice Address - Country:US
Practice Address - Phone:765-561-2956
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-07-14
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05003762A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty