Proteam Tactical Performance
Physical Medicine & Rehabilitation in Indianapolis, IN. Organization (NPI-2).
NPI number1669941514
StatusActive
Last updated in NPPESDec 15, 2020
Details
- NPI
- 1669941514
- Entity type
- Organization (NPI-2)
- Legal business name
- Proteam Tactical Performance
- Organization subpart
- No
- Enumeration date
- Nov 21, 2018
- Certification date
- Dec 15, 2020
- Last updated
- Dec 15, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | – | – | Yes |
| 2255A2300X | Specialist/Technologist, Athletic Trainer | – | – |
Practice location
8025 Combs RdIndianapolis, IN 46237-9588
Phone 317-804-3501
Mailing address
1531 E Northfield DrBrownsburg, IN 46112-2513
Other practice locations
200 E 186th St
Westfield, IN 46074-2001
Westfield, IN 46074-2001
Phone 317-804-3501
901 N Post Rd
Indianapolis, IN 46219-5545
Indianapolis, IN 46219-5545
Phone 317-327-2047
Authorized official
Joey Vandever
Ceo
3178928180
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