Provider Demographics
NPI:1487698692
Name:CHUNDI, PRAMDASHREE (MS PT)
Entity type:Individual
Prefix:
First Name:PRAMDASHREE
Middle Name:
Last Name:CHUNDI
Suffix:
Gender:F
Credentials:MS PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:18275 N 59TH AVE BLDG G
Mailing Address - Street 2:SUITE#142
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-1260
Mailing Address - Country:US
Mailing Address - Phone:602-978-9191
Mailing Address - Fax:602-564-0111
Practice Address - Street 1:18275 N 59TH AVE BLDG G
Practice Address - Street 2:SUITE#142
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-1260
Practice Address - Country:US
Practice Address - Phone:602-978-9191
Practice Address - Fax:602-564-0111
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-16
Last Update Date:2007-08-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5501011789225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist