MEDICARE: MARCEL Y OSHIKAWA PT

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	225100000X	Physical Therapist	99037131A	IN

General Provider Information

NPI Number	:	1134363633
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARCEL Y OSHIKAWA PT

Provider Business Mailing Address
First Line	:	1400 HIGHLAND RD
Second Line	:	SUITE 4
City	:	RICHMOND
State	:	IN
Zip	:	47374-8809
Country	:	US
Telephone Number	:	765-939-0820
Fax Number	:	765-939-0920

Provider Business Practice Location Address
First Line	:	1400 HIGHLAND RD
Second Line	:	SUITE 4
City	:	RICHMOND
State	:	IN
Zip	:	47374-8809
Country	:	US
Telephone Number	:	765-939-0820
Fax Number	:	765-939-0920

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

Provider Enumeration Date	:	04/28/2009
Last Update Date	:	04/28/2009

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