Individual
MR. GITHU POKKAMTHANAM GEORGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
9500 GRAND RIVER AVE, DETROIT, MI 48204-2132
(678) 522-1084
Mailing address
41039 SCARBOROUGH LN, NOVI, MI 48375-2889
(678) 522-1084
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502002824
MI
Other
Enumeration date
12/23/2021
Last updated
12/23/2021
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