Doctor Name: | SRIKANTH PEACHERA |
NPI Number: | 1053682633 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 5501012227 |
Business Practice Address: | 4705 Towne Centre Rd Ste 101 Saginaw, MI - 48604 |
Business Phone Number: | 9894015890 |
Business Fax Number: | 9894015892 |
Mailing Address: | 61 Commerce Ave Sw, GRAND RAPIDS |
State: | MI |
Postal Code: | 49503 |
Phone Number: | 6169400660 |
Fax Number: | 6169401965 |
NPI Enumeration Date: | 01/13/2012 |
NPI Last Update Date: | 09/10/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501012227 |
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 |