Healthcare Provider Details

I. General information

NPI: 1326963331
Provider Name (Legal Business Name): AARON E RIVERA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1431 S LAKE PARK AVE
HOBART IN
46342-6635
US

IV. Provider business mailing address

1431 S LAKE PARK AVE
HOBART IN
46342-6635
US

V. Phone/Fax

Practice location:
  • Phone: 219-945-3269
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number06004428A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: