Individual
MS. CHETNA VIPUL DESAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
4655 DOBIE RD, SUITE 240, OKEMOS, MI 48864-2233
(517) 282-7107
Mailing address
4655 DOBIE RD, SUITE 240, OKEMOS, MI 48864-2233
(517) 282-7107
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5501005992
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501005992
MI LICENSE NUMBER
MI
01
—
650C31212
MIBLUE CROSS BLUE SHIELD
MI
Enumeration date
07/27/2006
Last updated
11/13/2013
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