Individual
SUDHAKARAN JEGADEESH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, MBA
Contact information
Practice address
17418 W 10 MILE RD, SOUTHFIELD, MI 48075-2951
(248) 552-1012
(248) 552-0657
Mailing address
17418 W 10 MILE RD, SOUTHFIELD, MI 48075-2951
(248) 552-1012
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501007156
MI
2251X0800X
Orthopedic Physical Therapist
Primary
5501007156
MI
Other
Enumeration date
05/30/2007
Last updated
10/07/2011
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