Individual
MR. TONY THOTTUKADAVIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.O.
Taxonomy
Speciality
Code
Description
License number
State
1744P3200X
Prosthetics Case Management
—
—
222Z00000X
Orthotist
Primary
C52463
OK
Other
Enumeration date
03/30/2017
Last updated
04/12/2019
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