| Mr Jaya Prakash Boddu, PT | |
|
1447 E Grand River Ave, Health Source Physical Therapy Center,inc., Portland, MI 48875-9687 | |
| (517) 647-1000 | |
| (517) 647-1100 |
| Full Name | Mr Jaya Prakash Boddu |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist |
| Location | 1447 E Grand River Ave, Portland, Michigan |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023235777 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 5501005495 (Michigan) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Jaya Prakash Boddu, PT 1447 E Grand River Ave, Health Source Physical Therapy Center,inc., Portland, MI 48875-9687 Ph: (517) 647-1000 | Mr Jaya Prakash Boddu, PT 1447 E Grand River Ave, Health Source Physical Therapy Center,inc., Portland, MI 48875-9687 Ph: (517) 647-1000 |
Lauren Beers, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 9751 E Grand River Ave Ste 1, Portland, MI 48875 Phone: 517-376-3650 | |
Erica Foresman, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 1447 E Grand River Ave, Portland, MI 48875 Phone: 517-647-1000 | |
Samantha Leigh Newell, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 1447 E Grand River Ave, Portland, MI 48875 Phone: 517-647-1000 | |
Dr. Jesudian Boddu, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 1447 E Grand River Ave, Portland, MI 48875 Phone: 517-647-1000 |