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1114371275
REVANTH MOPURU
EAST LANSING, MI
NPI
1114371275
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501013417)
Enumeration Date
2016-04-14
Last Update Date
2016-04-14
Business Address
REVANTH MOPURU
2815 NORTHWIND DR
EAST LANSING, MI 48823-5003
Phone number: 517-332-0817
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Mailing Address
REVANTH MOPURU
6140 HARDY AVE APT 11
EAST LANSING, MI 48823-1589
Phone number: 573-639-0181
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