Provider Demographics
NPI:1871217257
Name:FELIPE, EMMANUEL CAMINO
Entity type:Individual
Prefix:
First Name:EMMANUEL
Middle Name:CAMINO
Last Name:FELIPE
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 1:13921 WASHITA CT
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46033-8550
Mailing Address - Country:US
Mailing Address - Phone:317-645-5249
Mailing Address - Fax:
Practice Address - Street 1:5045 W 52ND ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46254-1705
Practice Address - Country:US
Practice Address - Phone:317-293-2929
Practice Address - Fax:317-449-5783
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2024-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist