Provider Demographics
NPI:1730621228
Name:TOMCZUK, LINDA (DPT)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:TOMCZUK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14253 KEYESPORT LNDG
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46040-8103
Mailing Address - Country:US
Mailing Address - Phone:765-643-8781
Mailing Address - Fax:765-622-0126
Practice Address - Street 1:2976 N SCATTERFIELD RD
Practice Address - Street 2:150
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46012-1585
Practice Address - Country:US
Practice Address - Phone:765-643-8781
Practice Address - Fax:765-622-0126
Is Sole Proprietor?:No
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05011546A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist