Individual
ANBU PUNNIYAKOTTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
49628 GREAT FALLS RD, CANTON, MI 48188-3459
(734) 397-2830
(734) 397-4918
Mailing address
49628 GREAT FALLS RD, CANTON, MI 48188-3459
(734) 397-2830
(734) 397-4918
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501007005
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
65-O-H2-2460-0
BCBS
MI
Enumeration date
08/26/2007
Last updated
08/26/2007
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