Individual
HARISH SATHRI JEDEDIAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12855 DIX TOLEDO RD, SOUTHGATE, MI 48195-1744
(586) 219-1290
Mailing address
1595 BEACHWOOD DR, WALLED LAKE, MI 48390-5881
(586) 219-1290
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
07/21/2022
Last updated
09/06/2022
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