Provider Demographics
NPI:1952798225
Name:VEMURI, PURNIMA
Entity Type:Individual
Prefix:
First Name:PURNIMA
Middle Name:
Last Name:VEMURI
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 1:4258 HIGHWAY 49 S UNIT 554
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:NC
Mailing Address - Zip Code:28075-0137
Mailing Address - Country:US
Mailing Address - Phone:704-559-9409
Mailing Address - Fax:704-731-0975
Practice Address - Street 1:4258 HIGHWAY 49 S UNIT 554
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:NC
Practice Address - Zip Code:28075-0137
Practice Address - Country:US
Practice Address - Phone:704-559-9409
Practice Address - Fax:704-731-0975
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP14442225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist