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Individual

AMANDA JAYASHKI NUGALIYADDA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
22250 PROVIDENCE DR STE 405, SOUTHFIELD, MI 48075-6212
(866) 974-2673
(866) 939-2673
Mailing address
33900 HARPER AVE STE 104, CLINTON TWP, MI 48035-4258

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501303372
MI
225200000X
Physical Therapy Assistant
5502005497
MI

Other

Enumeration date
04/05/2018
Last updated
03/30/2026
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