MEDICARE: MR. DARREN CHITTICK LMT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225700000X	Massage Therapist	MT22308104	IN

General Provider Information

NPI Number	:	1093573396
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. DARREN CHITTICK LMT

Provider Business Mailing Address
First Line	:	1129 N OAKLAND AVE
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46201-2220
Country	:	US
Telephone Number	:	317-640-1553
Fax Number	:

Provider Business Practice Location Address
First Line	:	7780 MICHIGAN RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46268-2374
Country	:	US
Telephone Number	:	463-241-6090
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/11/2024
Last Update Date	:	03/11/2024

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Directions to “ MR. DARREN CHITTICK LMT” Practice Location

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