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General NPI Number Information
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NPI Number | 1518580521
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Entity Type | Individual
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Provider Name | MOXI TRIVEDI
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Gender | Female
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Dates
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Enumeration Date | 05/26/2020
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Last Update Date | 05/26/2020
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Provider Practice Location Address
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Address Line | 5080 N STATE ROAD 135 STE G
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City | BARGERSVILLE
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State | IN
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Zip | 46106-8941
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Country | US
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Telephone | 317-893-2449
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Fax |
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Provider Business Mailing Address
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Address Line | 8434 PENBROOKE PL
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City | INDIANAPOLIS
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State | IN
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Zip | 46237-8755
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Country | US
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Telephone | 317-489-8210
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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 | 05010343A
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License Number State | IN
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