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General NPI Number Information
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NPI Number | 1801020045
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Entity Type | Individual
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Provider Name | PULIANTHURUTHIL JOSEPH THOMAS NCTM
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Gender | Male
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Dates
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Enumeration Date | 05/02/2009
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Last Update Date | 06/02/2009
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Provider Practice Location Address
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Address Line | 22548-RAMBLING DRIVE
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City | MACOMB
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State | MI
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Zip | 48044-3739
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Country | US
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Telephone | 586-468-0312
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Fax | 586-468-0312
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Provider Business Mailing Address
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Address Line | 22548-RAMBLING DRIVE
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City | MACOMB
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State | MI
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Zip | 48044-3739
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Country | US
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Telephone | 586-468-0312
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Fax | 586-468-0312
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 173C00000X
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Taxonomy Name | Reflexologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 175F00000X
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Taxonomy Name | Naturopath
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License Number |
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License Number State |
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