Provider Demographics
NPI:1942525886
Name:KALRA, AMIT (RPT)
Entity Type:Individual
Prefix:
First Name:AMIT
Middle Name:
Last Name:KALRA
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:940 WOODED TRL APT 7
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-8710
Mailing Address - Country:US
Mailing Address - Phone:818-312-6072
Mailing Address - Fax:
Practice Address - Street 1:1350 N TODD DR
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7755
Practice Address - Country:US
Practice Address - Phone:812-752-5663
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-04
Last Update Date:2010-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05010166A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist