Individual
ANITHA SUDINI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
2927 ADDISON LN, JOHNS CREEK, GA 30005-5052
(732) 597-3757
Mailing address
2927 ADDISON LN, JOHNS CREEK, GA 30005-5052
(732) 597-3757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501012448
MI
225100000X
Physical Therapist
Primary
PT011791
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501012448
STATE LICENCE
MI
01
—
PT011791
STATE LICENSE
GA
Enumeration date
09/28/2006
Last updated
01/20/2015
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