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Individual

BRIAN L. STOCKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MPT

Contact information

Practice address
1081 BROAD RIPPLE AVE, INDIANAPOLIS, IN 46220-2034
(317) 808-0350
(317) 808-0349
Mailing address
33900 HARPER AVE STE 104, CLINTON TOWNSHIP, MI 48035-4258
(586) 416-9100
(586) 416-9103

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009690A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
100257920
GROUP MEDICAID
IN
01
156546
GROUP MEDICARE
IN
05
200930400A
IN
Enumeration date
12/10/2008
Last updated
04/23/2026
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