| NPI | 1629447719 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVITHA RUKKANNAGARI REDDY Physician 810-410-5148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: MI 4301085040) |
| Enumeration Date | 2015-09-18 |
| Last Update Date | 2016-11-17 |