Individual
BIMAL BASUKALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
118 MEDICAL DR, CARMEL, IN 46032-3323
(317) 844-4211
Mailing address
13888 ROYAL SADDLE DR, CARMEL, IN 46032-9040
(510) 283-4823
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012716A
IN
Other
Enumeration date
10/02/2023
Last updated
10/02/2023
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