Provider Demographics
NPI:1225173065
Name:SANGHVI, KRUTI AMIT (PT)
Entity Type:Individual
Prefix:
First Name:KRUTI
Middle Name:AMIT
Last Name:SANGHVI
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46743 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-4298
Mailing Address - Country:US
Mailing Address - Phone:734-837-9673
Mailing Address - Fax:734-981-8062
Practice Address - Street 1:46743 WOODSIDE DR
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-4298
Practice Address - Country:US
Practice Address - Phone:734-837-9673
Practice Address - Fax:734-981-8062
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501008866225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist