Provider Demographics
NPI:1821377730
Name:JELDI, ARUN K (PT)
Entity type:Individual
Prefix:
First Name:ARUN
Middle Name:K
Last Name:JELDI
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 1:14074 TRADE CENTER DR 232
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-4577
Mailing Address - Country:US
Mailing Address - Phone:765-299-3644
Mailing Address - Fax:
Practice Address - Street 1:12049 BOOTHBAY LN
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46037-7884
Practice Address - Country:US
Practice Address - Phone:765-299-3644
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-09
Last Update Date:2015-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN05009803A225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist