Healthcare Provider Details

I. General information

NPI: 1275767428
Provider Name (Legal Business Name): DAVID ABHISHEK KHOSA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/02/2009
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 E 86TH ST
INDIANAPOLIS IN
46240-1803
US

IV. Provider business mailing address

757 E 86TH ST
INDIANAPOLIS IN
46240-1803
US

V. Phone/Fax

Practice location:
  • Phone: 317-967-8787
  • Fax: 317-316-0049
Mailing address:
  • Phone: 317-967-8787
  • Fax: 317-316-0049

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number05009780A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: