Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 31002257A | IN |
NPI | 1073844072 |
---|---|
Provider Name | Mr. Todd E Meller |
First Address | Indianapolis, IN 46280-1393 |
Second Address | Indianapolis, IN 46280-1393 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/01/2010 |
Last Update Date | 12/03/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200151990 | (05) | IN |