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
Fax: (219) 472-0841
Website:

Health care specialties

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710930011 NPPES
Indiana MEDICAID 201269820A

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