Provider Demographics
NPI:1467628305
Name:GALHOTRA, PAWAN PUNEET (PT)
Entity Type:Individual
Prefix:MR
First Name:PAWAN
Middle Name:PUNEET
Last Name:GALHOTRA
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5466 WALNUT KNOLL CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48323-2550
Mailing Address - Country:US
Mailing Address - Phone:248-706-3222
Mailing Address - Fax:
Practice Address - Street 1:5466 WALNUT KNOLL CT
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323-2550
Practice Address - Country:US
Practice Address - Phone:248-706-3222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007020225100000X
CA33924225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist