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1710930011
FATAI BOLAJI ADISA
MERRILLVILLE, IN
NPI
1710930011
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: IN 05005905A)
Enumeration Date
2006-05-18
Last Update Date
2019-11-20
Business Address
FATAI BOLAJI ADISA PT
8691 CONNECTICUT ST STE C
MERRILLVILLE, IN 46410-5541
Phone number: 219-525-4176
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Mailing Address
FATAI BOLAJI ADISA PT
PO BOX 10644
MERRILLVILLE, IN 46411-0644
Phone number: 219-525-4176
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