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Individual
VENKATA JAYA MADHURI BONGARALA
Active
Individual
VENKATA JAYA MADHURI BONGARALA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
05006453A
IN
225100000X
Physical Therapist
Primary
070011570
IL
225100000X
Physical Therapist
40QA00867600
NJ
225100000X
Physical Therapist
5501008631
MI
Other
Enumeration date
01/27/2015
Last updated
01/27/2015
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