Organization
BODY OPULENCE THERAPY AND PERFORMANCE
Active
Other names
Opulent Rehab Services
Organization subpart
No
Provider details
NPI number
Authorized official
BRYAN ONUSELOGU DPT (PHYSICAL THERAPIST)
(773) 503-7511
Entity
Organization
Contact information
Practice address
1848 E 87TH AVE, MERRILLVILLE, IN 46410-7187
(773) 503-7511
Mailing address
5534 SAINT JOE RD, FORT WAYNE, IN 46835-3328
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
2251E1200X
Ergonomics Physical Therapist
—
—
2251G0304X
Geriatric Physical Therapist
—
—
2251N0400X
Neurology Physical Therapist
—
—
2251S0007X
Sports Physical Therapist
—
—
2251X0800X
Orthopedic Physical Therapist
—
—
Other
Enumeration date
07/16/2020
Last updated
07/16/2020
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