Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 0119003801 | VA |
NPI | 1164573218 |
---|---|
Provider Name | Mr. Bharat K Vallurupalli |
First Address | Vienna, VA 22180-5677 |
Second Address | Vienna, VA 22180-5677 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 03/11/2011 |