Individual
MR. MANOJ KUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR, CHT
Contact information
Practice address
611 E DOUGLAS ROAD, SUITE 108, MISHAWAKA, IN 46545
(574) 968-3520
(574) 217-4824
Mailing address
611 E DOUGLAS ROAD, SUITE 108, MISHAWAKA, IN 46545
(574) 968-3520
(574) 217-4824
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
31001173A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
200332623
TAX ID
IN
05
—
201299780
—
IN
Enumeration date
11/18/2005
Last updated
03/24/2017
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