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General NPI Number Information
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NPI Number | 1417001959
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Entity Type | Individual
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Provider Name | VEERASAMY SIVAKUMAR RPT
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Gender | Male
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Dates
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Enumeration Date | 01/22/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 29510 7 MILE RD
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City | LIVONIA
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State | MI
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Zip | 48152-1910
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Country | US
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Telephone | 248-427-9525
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Fax | 248-427-9528
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Provider Business Mailing Address
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Address Line | 8611 HICKORY DR BUILDING 2 APT F
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City | STERLING HEIGHTS
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State | MI
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Zip | 48312-4761
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Country | US
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Telephone | 586-979-5517
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Fax | 586-979-5517
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501005743
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License Number State | MI
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