Provider Demographics
NPI:1538866066
Name:BURNS PHYSICAL THERAPY AND WELLNESS COMPANY
Entity type:Organization
Organization Name:BURNS PHYSICAL THERAPY AND WELLNESS COMPANY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JARRED
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:260-241-1137
Mailing Address - Street 1:13839 AMSTUTZ RD
Mailing Address - Street 2:
Mailing Address - City:LEO
Mailing Address - State:IN
Mailing Address - Zip Code:46765-9605
Mailing Address - Country:US
Mailing Address - Phone:260-257-8956
Mailing Address - Fax:833-579-2878
Practice Address - Street 1:13839 AMSTUTZ RD
Practice Address - Street 2:
Practice Address - City:LEO
Practice Address - State:IN
Practice Address - Zip Code:46765-9605
Practice Address - Country:US
Practice Address - Phone:260-257-8956
Practice Address - Fax:833-579-2878
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-15
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN05013272AOtherSTATE MEDICAL LICENSE