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1851894638
SHANTHI VARDHANREDDY GANGUMALLA
DETROIT, MI
NPI
1851894638
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501014970)
Enumeration Date
2018-03-17
Last Update Date
2018-03-17
Business Address
Mr. SHANTHI VARDHANREDDY GANGUMALLA Physical Therapist
2567 W GRAND BLVD
DETROIT, MI 48208-1235
Phone number: 313-895-5340
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Mailing Address
Mr. SHANTHI VARDHANREDDY GANGUMALLA Physical Therapist
3946 MESA DR
TROY, MI 48083-6510
Phone number: 334-332-8310
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