Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501011786 | MI |
N | 2251G0304X | Physical Therapist - Geriatrics | 5501011786 | MI |
N | 2251N0400X | Physical Therapist - Neurology | 5501011786 | MI |
N | 2251X0800X | Physical Therapist - Orthopedic | 5501011786 | MI |
NPI | 1346385309 |
---|---|
Provider Name | Anjali S Gadkari |
First Address | Southfield, MI 48075-1281 |
Second Address | Southfield, MI 48075-1281 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 15/03/2010 |