Individual
KALYAN KONDETI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1751 WESLEY RD, AUBURN, IN 46706-3647
(260) 925-5494
Mailing address
1751 WESLEY RD, AUBURN, IN 46706-3647
(260) 925-5494
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05012482A
IN
Other
Enumeration date
08/28/2018
Last updated
08/28/2018
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