Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501006896 | MI |
N | 2251E1200X | Ergonomics | 5501006896 | MI |
N | 225XE1200X | Ergonomics | 5501006896 | MI |
N | 2251G0304X | Physical Therapist - Geriatrics | 5501006896 | MI |
N | 2251H1200X | Hand | 5501006896 | MI |
N | 2251S0007X | Physical Therapist - Sports | 5501006896 | MI |
N | 2251X0800X | Physical Therapist - Orthopedic | 5501006896 | MI |
NPI | 1801970082 |
---|---|
Provider Name | Mr. Sailesh Satpathy |
First Address | Kalamazoo, MI 49009-9007 |
Second Address | Kalamazoo, MI 49009-9007 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 15/08/2017 |