Individual
LAKSHMI KALYANI GUDAVALLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
275 E CARL SANDBURG DRIVE, MARIGOLD REHABILITATION, GALESBURG, IL 61401
(309) 344-1151
Mailing address
2834 VILLA CT, BETTENDORF, IA 52722-7554
(563) 639-2486
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
070020357
IL
Other
Enumeration date
09/18/2014
Last updated
09/18/2014
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