NPI 1023235777 MR. JAYA PRAKASH BODDU PT PORTLAND MI. Find Phone Number, Address, Contact details of medical healthcare providers | NPI Number Lookup

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Mr. Jaya Prakash Boddu - NPI: 1023235777

National Provider Identifier (NPI) is a 10-digit identification number which is issued to health care providers by the Centers for Medicare and Medicaid Services (CMS) in the United States(US). The NPI is introduced to replace of UPIN (unique provider identification number) and now NPI is the only required identifier for Medicare services, and NPI is also used by commercial healthcare insurers and by other payers.

Doctor Name: MR. JAYA PRAKASH BODDU
NPI Number: 1023235777
Entity Type Code: Individual (1)
Gender: M
Credentials: PT
License Number: 5501005495
Business Practice Address: 1447 E Grand River Ave
Health Source Physical Therapy Center,inc. Portland, MI - 488759687
Business Phone Number: 5176471000
Business Fax Number: 5176471100
Mailing Address: 1447 E Grand River Ave, Health Source Physical Therapy Center,inc.
PORTLAND
State: MI
Postal Code: 488759687
Phone Number: 5176471000
Fax Number: 5176471100
NPI Enumeration Date: 04/20/2007
NPI Last Update Date: 07/08/2007
Replacement NPI: 0
NPI Deactivation Date:
NPI Reactivation Date:

Taxonomy Information:

Healthcare Provider Taxonomy: 225100000X
License Number: 5501005495
Healthcare Provider Taxonomy:
(Secondary)
Y
State: MI
Taxonomy Type: Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Classification: Physical Therapist
Taxonomy Specialization:
Taxonomy Definition:
(1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT


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