| NPI | 1649472960 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVI B KUKKALLI President/Administrator 734-727-1309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2007-05-31 |
| Last Update Date | 2024-10-15 |