| Organization Name: | KIDS FOR LIFE PHYSICAL THERAPY INC. |
| NPI Number: | 1639389067 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | MARIA FILIPINA MARIANO PANTIG (PHYSICAL THERAPIST) |
| Mailing Address: | 19167 Glendale Ave South Bend |
| State: | IN US |
| Postal Code: | 466372706 |
| Phone Number: | 5742731442 |
| Fax Number: | 5742731442 |
| NPI Enumeration Date: | 05/23/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05003203A |
| 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 |