Healthcare Provider Details

I. General information

NPI: 1265062079
Provider Name (Legal Business Name): KOMPASHINET REHAB LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 01/21/2020
Certification Date: 01/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 KNIGHTSBRIDGE LANE
FISHERS IN
46037-9151
US

IV. Provider business mailing address

1130 KNIGHTSBRIDGE LANE
FISHERS IN
46037-9151
US

V. Phone/Fax

Practice location:
  • Phone: 317-992-3132
  • Fax: 317-578-3638
Mailing address:
  • Phone: 317-992-3132
  • Fax: 317-578-3638

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: GAMAL ELSAYED
Title or Position: OWNER
Credential: PT
Phone: 317-992-3132