Provider Demographics
NPI:1851720106
Name:MEHRINGER, LUKE
Entity Type:Individual
Prefix:
First Name:LUKE
Middle Name:
Last Name:MEHRINGER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3737 KNICKERBOCKER PL
Mailing Address - Street 2:APT 1F
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46240-7609
Mailing Address - Country:US
Mailing Address - Phone:812-630-6089
Mailing Address - Fax:
Practice Address - Street 1:3737 KNICKERBOCKER PL
Practice Address - Street 2:APT 1F
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46240-7609
Practice Address - Country:US
Practice Address - Phone:812-630-6089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-07
Last Update Date:2013-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN36002095A2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer