Provider Demographics
NPI:1427759026
Name:SAI PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:SAI PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ORGANIZER
Authorized Official - Prefix:
Authorized Official - First Name:MAHESH KUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:KODIKALLA SRINIVASULU
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:517-315-3347
Mailing Address - Street 1:1633 LEJACK CIR
Mailing Address - Street 2:
Mailing Address - City:FOREST
Mailing Address - State:VA
Mailing Address - Zip Code:24551-1295
Mailing Address - Country:US
Mailing Address - Phone:517-315-3347
Mailing Address - Fax:
Practice Address - Street 1:1633 LEJACK CIR
Practice Address - Street 2:
Practice Address - City:FOREST
Practice Address - State:VA
Practice Address - Zip Code:24551-1295
Practice Address - Country:US
Practice Address - Phone:517-315-3347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty