Organization
RCA PHYSICAL THERAPY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FATAI BOLAJI ADISA P.T., D.P.T (ADMINISTRATOR)
(219) 313-0763
Entity
Organization
Contact information
Practice address
8691 CONNECTICUT ST STE C, MERRILLVILLE, IN 46410-5541
(219) 525-4176
(219) 472-0841
Mailing address
PO BOX 10644, MERRILLVILLE, IN 46411-0644
(219) 525-4176
(219) 750-9451
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1710930011
INDIVIDUAL NPI
IN
01
—
225100000X
TAXONOMY
IN
Enumeration date
07/07/2014
Last updated
11/20/2019
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