Provider Demographics
NPI:1730912536
Name:A STEP AHEAD PEDIATRIC THERAPY
Entity type:Organization
Organization Name:A STEP AHEAD PEDIATRIC THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WAGERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-314-2378
Mailing Address - Street 1:4610 25TH ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47203-3239
Mailing Address - Country:US
Mailing Address - Phone:812-314-2378
Mailing Address - Fax:812-373-7616
Practice Address - Street 1:420 N STATE ST STE B
Practice Address - Street 2:
Practice Address - City:NORTH VERNON
Practice Address - State:IN
Practice Address - Zip Code:47265-1040
Practice Address - Country:US
Practice Address - Phone:812-314-2378
Practice Address - Fax:812-373-7616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty