Provider Demographics
NPI:1730409277
Name:MIDWEST REHABILITATIVE MEDICINE
Entity type:Organization
Organization Name:MIDWEST REHABILITATIVE MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:WINCHESTER
Authorized Official - Suffix:
Authorized Official - Credentials:SLPA
Authorized Official - Phone:317-379-4894
Mailing Address - Street 1:14350 MUNDY DR
Mailing Address - Street 2:SUITE 800 290
Mailing Address - City:NOBLESVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46060-7223
Mailing Address - Country:US
Mailing Address - Phone:888-486-5157
Mailing Address - Fax:
Practice Address - Street 1:14350 MUNDY DR
Practice Address - Street 2:SUITE 800 290
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-7223
Practice Address - Country:US
Practice Address - Phone:888-486-5157
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-07
Last Update Date:2010-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health