| Doctor Name: | DR. GISOU BEHROUZI |
| NPI Number: | 1730430570 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPT., DPT |
| License Number: | 05005665A |
| Business Practice Address: | 3801 Old Bruceville Rd Vincennes, IN - 475913889 |
| Business Phone Number: | 8128864677 |
| Business Fax Number: | 8128864678 |
| Mailing Address: | 501 S Brook Ave, MISHAWAKA |
| State: | IN |
| Postal Code: | 465443405 |
| Phone Number: | 5748508710 |
| Fax Number: | |
| NPI Enumeration Date: | 09/19/2012 |
| NPI Last Update Date: | 09/19/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05005665A |
| 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 |