Provider Demographics
NPI:1639279359
Name:GURU, ANAR DESAI (DPT)
Entity Type:Individual
Prefix:MR
First Name:ANAR
Middle Name:DESAI
Last Name:GURU
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 DEER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:HOLLY
Mailing Address - State:MI
Mailing Address - Zip Code:48442-1561
Mailing Address - Country:US
Mailing Address - Phone:248-634-1785
Mailing Address - Fax:
Practice Address - Street 1:1016 N SAGINAW ST
Practice Address - Street 2:SUITE B
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-1351
Practice Address - Country:US
Practice Address - Phone:248-634-4424
Practice Address - Fax:248-634-5995
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011475225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist