OrganizationActive
Pediatric Rehabilitation of Indiana, Inc
NPI 1629286794 · Pediatric Rehabilitation Medicine Physician · Indianapolis, IN
Provider details
- NPI number
- 1629286794
- Entity type
- Organization
- Primary specialty
- Pediatric Rehabilitation Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Susan Dieterich, Owner(361) 548-5270
- License
- 01043182A (IN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Practice location
3825 N Meridian St
Indianapolis, IN 46208-4018
Phone: (361) 548-5270
Approximate (ZIP-level) locationGet directions
Mailing address
5006 Deer Park Cir
Corpus Christi, TX 78413-6027
Registry dates
- Enumerated
- 2007-05-20
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.