Provider Demographics
NPI:1215262316
Name:OJILI, VENKATA
Entity type:Individual
Prefix:
First Name:VENKATA
Middle Name:
Last Name:OJILI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 JEFFERSON POINT LN
Mailing Address - Street 2:APT 1-B
Mailing Address - City:NEWPORT NEWS
Mailing Address - State:VA
Mailing Address - Zip Code:23602-8132
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:235 E MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:NORTHVILLE
Practice Address - State:MI
Practice Address - Zip Code:48167-2494
Practice Address - Country:US
Practice Address - Phone:866-874-0036
Practice Address - Fax:248-349-7575
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2009-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist