Individual
BALA NIKLESH REDDY POTHIREDDY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1311 GENERAL CAVAZOS BLVD, KINGSVILLE, TX 78363-7150
(361) 595-9405
Mailing address
1311 GENERAL CAVAZOS BLVD, KINGSVILLE, TX 78363-7150
(361) 595-1661
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1270686
TX
Other
Enumeration date
09/18/2019
Last updated
09/18/2019
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