Individual
HARITHEESAN PEETHAMBARAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
1893 E LA DONNA DR, TEMPE, AZ 85283-3256
(480) 452-9047
Mailing address
1893 E LA DONNA DR, TEMPE, AZ 85283-3256
(480) 452-9047
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0013029
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0013029
MEDICARE
CO
Enumeration date
07/31/2013
Last updated
07/31/2013
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