Provider Demographics
NPI:1134363633
Name:OSHIKAWA, MARCEL Y (PT)
Entity type:Individual
Prefix:
First Name:MARCEL
Middle Name:Y
Last Name:OSHIKAWA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 HIGHLAND RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47374-8809
Mailing Address - Country:US
Mailing Address - Phone:765-939-0820
Mailing Address - Fax:765-939-0920
Practice Address - Street 1:1400 HIGHLAND RD
Practice Address - Street 2:SUITE 4
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-8809
Practice Address - Country:US
Practice Address - Phone:765-939-0820
Practice Address - Fax:765-939-0920
Is Sole Proprietor?:No
Enumeration Date:2009-04-28
Last Update Date:2009-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN99037131A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist