Provider Demographics
NPI:1720789001
Name:PIMPALAPURE, SURBHI PRADEEP
Entity Type:Individual
Prefix:
First Name:SURBHI
Middle Name:PRADEEP
Last Name:PIMPALAPURE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3501 XENIUM LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-2212
Mailing Address - Country:US
Mailing Address - Phone:269-338-9677
Mailing Address - Fax:
Practice Address - Street 1:S820 WESTLAND DR
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:WI
Practice Address - Zip Code:54767-8241
Practice Address - Country:US
Practice Address - Phone:715-778-5535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist