Trademark Performance Corporation | |
1427 Lincoln Hwy Unit C, Dyer, IN 46311-2026 | |
(517) 425-2882 | |
Not Available |
Full Name | Trademark Performance Corporation |
---|---|
Type | Facility |
Speciality | Physical Therapist |
Location | 1427 Lincoln Hwy Unit C, Dyer, Indiana |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1457800443 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225100000X | Physical Therapist | (* (Not Available)) | Primary |
2255A2300X | Specialist/technologist - Athletic Trainer | (* (Not Available)) | Secondary |
Provider Name | David Ray Newbolds |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1881731818 PECOS PAC ID: 3173615994 Enrollment ID: I20070911000781 |
Provider Name | Amy Van Vossen |
---|---|
Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1750841276 PECOS PAC ID: 1850624552 Enrollment ID: I20190613003330 |
Mailing Address | Practice Location Address |
---|---|
Trademark Performance Corporation 9145 W 103rd St, Saint John, IN 46373-8794 Ph: () - | Trademark Performance Corporation 1427 Lincoln Hwy Unit C, Dyer, IN 46311-2026 Ph: (517) 425-2882 |
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