Provider Demographics
NPI:1982607495
Name:THERAPEUTIC TOUCH FOR INFANTS & CHILDREN, PC
Entity type:Organization
Organization Name:THERAPEUTIC TOUCH FOR INFANTS & CHILDREN, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:C
Authorized Official - Last Name:DIETZ
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:317-201-3754
Mailing Address - Street 1:12623 E 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46236-8548
Mailing Address - Country:US
Mailing Address - Phone:317-201-3754
Mailing Address - Fax:317-823-6484
Practice Address - Street 1:12623 E 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46236-8548
Practice Address - Country:US
Practice Address - Phone:317-201-3754
Practice Address - Fax:317-823-6484
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002030A2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000215001OtherANTHEM BC/BS IN NETWORK