Individual
AMISHA MUTHIALU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1030 N CLARK ST, CHICAGO, IL 60610-5467
(312) 238-7871
Mailing address
1030 N CLARK ST, CHICAGO, IL 60610-5467
(312) 238-7871
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
IL
Other
Enumeration date
04/02/2008
Last updated
04/02/2008
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