Organization · NPI-2

21st Century Total Wellness

Occupational Therapy Assistant · Merrillville, IN

NPI number1639218910
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1639218910
Entity type
Organization (NPI-2)
Legal business name
21st Century Total Wellness
Organization subpart
No
Enumeration date
Feb 5, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
224Z00000X Occupational Therapy Assistant32000255AINYes

Practice location

501 W 84th Dr Ste 1
Merrillville, IN 46410-7013

Phone 219-756-4695 · Fax 219-793-9629

Mailing address

501 W 84th Dr Ste 1
Merrillville, IN 46410-7013

Phone 219-756-4695 · Fax 219-793-9629

Authorized official

Edgar D Prater
President
2197564695

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