=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356265847
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | METTA MASSAGE STUDIO
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/06/2026
-----------------------------------------------------
Last Update Date | 08/06/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1610 S KITLEY AVE
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46203-2635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-223-3567
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1610 S KITLEY AVE
-----------------------------------------------------
City | INDIANAPOLIS
-----------------------------------------------------
State | IN
-----------------------------------------------------
Zip | 46203-2635
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 317-223-3567
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CEO
-----------------------------------------------------
Name | AMI HOCKMAN
-----------------------------------------------------
Credential | LMT
-----------------------------------------------------
Telephone | 317-223-3567
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------