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1992090625
KANISHKA THIRAN JAYASUNDERA
ANN ARBOR, MI
NPI
1992090625
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207W00000X Ophthalmology
(Licence: MI 4301093385)
Enumeration Date
2011-06-10
Last Update Date
2021-03-26
Business Address
KANISHKA THIRAN JAYASUNDERA
1000 WALL STREET
ANN ARBOR, MI 48105-1912
Phone number: 734-764-4190
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Mailing Address
KANISHKA THIRAN JAYASUNDERA
3621 S STATE ST
ANN ARBOR, MI 48108-1633
Phone number: 734-647-5299
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