Provider Demographics
NPI:1336418870
Name:SUNNY PHYSICALTHERAPY
Entity type:Organization
Organization Name:SUNNY PHYSICALTHERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:MR
Authorized Official - First Name:PEACHERA
Authorized Official - Middle Name:
Authorized Official - Last Name:SRIKANTH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:989-971-1144
Mailing Address - Street 1:3800 MORNINGSIDE LN
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48603-1283
Mailing Address - Country:US
Mailing Address - Phone:989-401-2611
Mailing Address - Fax:
Practice Address - Street 1:1525 W CARO RD
Practice Address - Street 2:
Practice Address - City:CARO
Practice Address - State:MI
Practice Address - Zip Code:48723-9686
Practice Address - Country:US
Practice Address - Phone:989-497-9970
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-28
Last Update Date:2012-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012227261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy