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Individual

MRS. RIDHIMA WASON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
426 S ALABAMA ST STE 200, INDIANAPOLIS, IN 46225-3301
(317) 528-6804
(317) 528-3781
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
(317) 865-1479

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009352A
IN
225100000X
Physical Therapist
21327
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000532223
ANTHEM/BCBS PIN
IN
01
1669672242
GROUP NPI
IN
05
200848350D
IN
05
200871250
IN
Enumeration date
11/08/2006
Last updated
09/28/2023
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