| Vinitha Kodali, PT, DPT | |
|
3000 Centerpoint Pkwy, Pontiac, MI 48341-3116 | |
| (248) 857-6776 | |
| (248) 857-7102 |
| Full Name | Vinitha Kodali |
|---|---|
| Gender | Female |
| Speciality | Physical Therapist |
| Location | 3000 Centerpoint Pkwy, Pontiac, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1457812760 | NPI | - | NPPES |
| 5501019552 | Other | MI | PT LICENSE |
| LPT30510 | Other | AZ | PHYSICAL THERAPY LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 30510 (Arizona) | Secondary |
| 225100000X | Physical Therapist | 5501019552 (Michigan) | Primary |
| Provider Name | Mansach Enterprises Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1477989937 PECOS PAC ID: 5991934184 Enrollment ID: O20140211000726 |
| Provider Name | Bluestone Childrens Center Llc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1841781531 PECOS PAC ID: 8325375561 Enrollment ID: O20190809001477 |
| Mailing Address | Practice Location Address |
|---|---|
| Vinitha Kodali, PT, DPT 3000 Centerpoint Pkwy, Pontiac, MI 48341-3116 Ph: (248) 857-6776 | Vinitha Kodali, PT, DPT 3000 Centerpoint Pkwy, Pontiac, MI 48341-3116 Ph: (248) 857-6776 |
Mrs. Anjani Vemireddy, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 Auburn Ave, Pontiac, MI 48342 Phone: 248-335-9490 | |
Thamilarasi Subramanian, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 50 N Perry St, Pontiac, MI 48342 Phone: 248-338-5000 | |
Sarah Smith, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 3000 Centerpoint Pkwy, Pontiac, MI 48341 Phone: 248-857-6776 Fax: 248-857-7102 | |
Shalin R Lashkari, MSPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 50 N Perry St, Pontiac, MI 48342 Phone: 248-338-5000 | |
Mrs. Michelle Marie Mcdonald, PT Physical Therapist Medicare: Medicare Enrolled Practice Location: 44555 Woodward Ave, Suite 080, Pontiac, MI 48341 Phone: 248-858-6950 | |
Triamsee Bandala, Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 Auburn Ave Ste 100, Pontiac, MI 48342 Phone: 248-332-8600 | |
Joel Thomas Sterling, P.T. Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 900 Auburn Ave, Pontiac, MI 48342 Phone: 248-333-3335 Fax: 248-333-0276 |