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General NPI Number Information
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NPI Number | 1265743629
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Entity Type | Individual
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Provider Name | ABHILEKH THAKUR PT
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Gender | Male
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 06/30/2010
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Provider Practice Location Address
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Address Line | 12803 LENOVER STREET
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City | DILLSBORO
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State | IN
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Zip | 47018
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Country | US
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Telephone | 812-432-5226
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Fax | 812-432-3311
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Provider Business Mailing Address
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Address Line | 15 OAKMONT PL APT# 217
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City | BATESVILLE
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State | IN
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Zip | 47006-6904
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Country | US
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Telephone | 812-717-0156
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05010203A
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License Number State | IN
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