Individual
JAYACHANDRA BOMMAREDDY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
17001 17 MILE RD, CLINTON TOWNSHIP, MI 48038-2801
(586) 286-7100
Mailing address
3198 FANTAIL DR, ROCHESTER HILLS, MI 48309-4292
(510) 565-4554
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013421
MI
Other
Enumeration date
03/19/2018
Last updated
03/19/2018
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