| Doctor Name: | VANESSA QUALLS |
| NPI Number: | 1093957284 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | 05004138A |
| Business Practice Address: | 118 Medical Dr Carmel, IN - 460322923 |
| Business Phone Number: | 3175731037 |
| Business Fax Number: | 8667854924 |
| Mailing Address: | 11192 Governors Ln, FISHERS |
| State: | IN |
| Postal Code: | 460378836 |
| Phone Number: | 3176523201 |
| Fax Number: | 8667854924 |
| NPI Enumeration Date: | 04/02/2009 |
| NPI Last Update Date: | 04/02/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05004138A |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IN |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |