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NPI Code Detail

MEDICARE: BALA THIRUKUMARAN PT

MEDICARE: BALA THIRUKUMARAN PT
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 Therapist5501007792MI

General Provider Information

NPI Number : 1801365242
Entity Type Code : Individual
Provider Name (Legal Business Name) : BALA THIRUKUMARAN PT
Provider Business Mailing Address
First Line : 925 W SOUTH BLVD
Second Line :
City : TROY
State : MI
Zip : 48085-1502
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 925 W SOUTH BLVD
Second Line :
City : TROY
State : MI
Zip : 48085-1502
Country : US
Telephone Number : 248-729-4400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2018
Last Update Date : 11/15/2018

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Directions to “ BALA THIRUKUMARAN PT” Practice Location

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