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Individual

ANSHUMALA M SHIVAKOTY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
4531 STONEBRIDGE DR, MACUNGIE, PA 18062-8715
(225) 229-5145
Mailing address
4531 STONEBRIDGE DR, MACUNGIE, PA 18062-8715
(225) 229-5145

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
2305206211
VA
225100000X
Physical Therapist
24749
MD
225100000X
Physical Therapist
Primary
PT023512
PA

Other

Enumeration date
02/22/2012
Last updated
09/20/2024
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