Provider Demographics
NPI:1760788533
Name:JALUKAR, PRAGYA (RPT)
Entity Type:Individual
Prefix:MRS
First Name:PRAGYA
Middle Name:
Last Name:JALUKAR
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9217 HACKBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4158
Mailing Address - Country:US
Mailing Address - Phone:248-227-1082
Mailing Address - Fax:
Practice Address - Street 1:37501 JOY RD
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-7538
Practice Address - Country:US
Practice Address - Phone:734-451-1155
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-01-26
Last Update Date:2011-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501011029225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist