Individual
THILAK PURUSHOTHAMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
5651 LIMESTONE RD, WILMINGTON, DE 19808-1217
(302) 239-8583
Mailing address
57 GLENCOE DR, NEWARK, DE 19702-2056
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
J1-0002405
DE
Other
Enumeration date
02/04/2019
Last updated
02/04/2019
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