| Organization Name: | PROVIDENCE REHABILITATION SERVICES, P.C. |
| NPI Number: | 1972626828 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DIANE TERPSTRA LARSEN (OWNER) |
| Mailing Address: | 8926 Arbor Hill Dr Highland |
| State: | IN US |
| Postal Code: | 463222100 |
| Phone Number: | 2197967273 |
| Fax Number: | 2199722830 |
| NPI Enumeration Date: | 04/07/2007 |
| NPI Last Update Date: | 06/20/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 05001734A |
| 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 |