Provider Demographics
NPI:1871718627
Name:MARY ALISON REED
Entity type:Organization
Organization Name:MARY ALISON REED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MARY
Authorized Official - Middle Name:ALISON
Authorized Official - Last Name:REED
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:317-328-0184
Mailing Address - Street 1:10742 MALONEY RD
Mailing Address - Street 2:
Mailing Address - City:BROWNSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:46112-9661
Mailing Address - Country:US
Mailing Address - Phone:317-328-0184
Mailing Address - Fax:317-292-9025
Practice Address - Street 1:10742 MALONEY RD
Practice Address - Street 2:
Practice Address - City:BROWNSBURG
Practice Address - State:IN
Practice Address - Zip Code:46112-9661
Practice Address - Country:US
Practice Address - Phone:317-328-0184
Practice Address - Fax:317-292-9025
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05002507A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200723460Medicare UPIN