Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Viswanatha R Mukkamalla, PHYSICALTHERAPIST

Individual provider Physical Therapist · NPI 1629572805

Viswanatha R Mukkamalla, PHYSICALTHERAPIST is a Physical Therapist in Southfield, Michigan. Works from 3 locations. Licensed in Michigan.

Licensed in
MI
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

17220 W 12 Mile Rd Ste 140
Southfield, MI 48076-2114
Phone: (248) 281-3428
Fax: (248) 281-3478
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (2)

  • 21017 Middlebelt Rd, Farmington Hills, MI 48336-5547 — (248) 476-8300
  • 6535 Drake Rd, West Bloomfield, MI 48322-3147 — (248) 592-2000

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501013960 (MI)
Physical Therapist Taxonomy 225100000X (MI)

Record details

NPI number1629572805
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICALTHERAPIST
Sole proprietorNo
NPI enumeratedMarch 21, 2018
Last updated in NPPESJune 1, 2022
Certification dateJune 1, 2022

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