Individual
GAURAV MITRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1769 S CEDAR ST, IMLAY CITY, MI 48444-1300
(810) 724-0421
(810) 721-0423
Mailing address
1769 S CEDAR ST, IMLAY CITY, MI 48444-1300
(810) 724-0421
(810) 721-0423
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013172
MI
Other
Enumeration date
10/17/2008
Last updated
03/24/2009
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