Provider Demographics
NPI:1639453046
Name:SIVASAKTHI HEALTH CARE PC
Entity Type:Organization
Organization Name:SIVASAKTHI HEALTH CARE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MUTHUKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SAKTHIVEL
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:248-275-5659
Mailing Address - Street 1:1889 CRIMSON DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-5510
Mailing Address - Country:US
Mailing Address - Phone:248-275-5659
Mailing Address - Fax:248-494-0491
Practice Address - Street 1:1889 CRIMSON DR
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-5510
Practice Address - Country:US
Practice Address - Phone:248-275-5659
Practice Address - Fax:248-494-0491
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-04
Last Update Date:2012-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005296225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty