Individual
MRS. ESTHER SUJA SELVAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHYSICAL THERAPIST
Contact information
Practice address
42657 GARFIELD RD, SUITE 212, CLINTON TOWNSHIP, MI 48038-5023
(586) 263-5375
Mailing address
42657 GARFIELD RD, SUITE 212, CLINTON TOWNSHIP, MI 48038-5023
(586) 263-5375
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501006000
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4741510
—
MI
01
—
65-OE00041-0
BCBS
MI
Enumeration date
10/16/2006
Last updated
07/08/2007
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