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NPI Code Detail

MEDICARE: ANIMMA AGITHAKUMAR

MEDICARE: ANIMMA AGITHAKUMAR
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501014439MI

General Provider Information

NPI Number : 1619440914
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANIMMA AGITHAKUMAR
Provider Business Mailing Address
First Line : 37135 BAKER DR
Second Line :
City : WESTLAND
State : MI
Zip : 48185-3767
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8365 N NEWBURGH RD
Second Line :
City : WESTLAND
State : MI
Zip : 48185-1149
Country : US
Telephone Number : 734-576-1365
Fax Number : 248-284-7525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2019
Last Update Date : 01/09/2019

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Directions to “ ANIMMA AGITHAKUMAR ” Practice Location

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