Organization
GOLDEN INNING
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RAVIKUMAR SHUKLA PHYSICAL THERAPIST (PHYSICAL THERAPIST)
(616) 780-6037
Entity
Organization
Contact information
Practice address
3437 MASON VIEW DR NE, GRAND RAPIDS, MI 49525-9538
(616) 780-6037
Mailing address
3437 MASON VIEW DR NE, GRAND RAPIDS, MI 49525-9538
(616) 780-6037
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
06/01/2022
Last updated
06/04/2022
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