Healthcare Provider Details

I. General information

NPI: 1083230536
Provider Name (Legal Business Name): MEHTA MOBILITY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/21/2020
Last Update Date: 06/21/2020
Certification Date: 06/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1192 ANGELIQUE CT
CARMEL IN
46032-9759
US

IV. Provider business mailing address

1192 ANGELIQUE CT
CARMEL IN
46032-9759
US

V. Phone/Fax

Practice location:
  • Phone: 317-413-7981
  • Fax:
Mailing address:
  • Phone: 317-413-7981
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: ALLYSSA MEHTA
Title or Position: OWNER
Credential: OTR
Phone: 317-413-7981