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Individual

JYOTHSNA VANGURU

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
4102 SHORE DR, INDIANAPOLIS, IN 46254-2608
(317) 347-9051
Mailing address
4350 MADISON AVE APT 308, INDIANAPOLIS, IN 46227-1571
(701) 212-6513

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009328A
IN
225100000X
Physical Therapist
5501013357
MI

Other

Enumeration date
08/20/2008
Last updated
01/04/2024
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