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General NPI Number Information
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NPI Number | 1578987152
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Entity Type | Organization
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Legal Business Name | MIMMS FUNCTIONAL REHABILITATION PC
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Dates
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Enumeration Date | 02/18/2014
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Last Update Date | 11/10/2025
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Provider Practice Location Address
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Address Line | 755 W CARMEL DR STE 215
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City | CARMEL
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State | IN
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Zip | 46032-5878
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Country | US
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Telephone | 317-781-0067
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Fax | 317-791-1242
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Provider Business Mailing Address
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Address Line | 755 W CARMEL DR STE 215
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City | CARMEL
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State | IN
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Zip | 46032-5878
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Country | US
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Telephone | 317-781-0067
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Fax | 317-791-1242
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. ANTHONY MIMMS
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Credential | MD
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Telephone | 317-781-0067
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 01059908
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License Number State | IN
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