Basic Information
| Provider Information | |||||||||
| NPI: | 1780811570 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | DHANDHUKIYA | ||||||||
| FirstName: | MALAY | ||||||||
| MiddleName: | R | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 710 NORTH AVE | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490173258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2697883040 | ||||||||
| FaxNumber: | 2697883043 | ||||||||
| Practice Location | |||||||||
| Address1: | 710 NORTH AVE | ||||||||
| Address2: | |||||||||
| City: | BATTLE CREEK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 490173258 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2697883040 | ||||||||
| FaxNumber: | 2697883043 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/18/2009 | ||||||||
| LastUpdateDate: | 09/01/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501013865 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.