Doctor Name: | THESHARA KULATILAKE |
NPI Number: | 1568700060 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | 5501016139 |
Business Practice Address: | 1170 Airport Centre Drive Suite 104 Romulus, MI - 48174 |
Business Phone Number: | 7349557000 |
Business Fax Number: | |
Mailing Address: | 109 Rock Rose Dr, BADEN |
State: | PA |
Postal Code: | 150059620 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/18/2013 |
NPI Last Update Date: | 01/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501016139 |
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 |