Adisa, Fatai Bolaji
Adisa, Fatai Bolaji is an sole proprietor health care provider with primary practice located at 8691 Connecticut St Ste C, Merrillville IN 46410-5541. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Adisa, Fatai Bolaji can be contacted via phone (219) 525-4176.Contact Information
Primary practice address
8691 Connecticut St Ste C
Merrillville IN 46410-5541
Phone: (219) 525-4176
Fax: (219) 472-0841
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist | 225100000X | 05005905A | Indiana |
Profile Details
NPI number | 1710930011 |
---|---|
LBN Legal business name | Adisa, Fatai Bolaji |
Credentials | Physical Therapist (PT) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | May 18th, 2006 |
Last updated | Nov 20th, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1710930011 | NPPES |
Indiana | MEDICAID | 201269820A |
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