Individual
BHAVIKKUMAR SHUKLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
275 W 12TH ST, 4 WEST, PERU, IN 46970-1638
(765) 475-2160
Mailing address
2547 ACORN DR, KOKOMO, IN 46902-7522
(404) 932-2878
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05010237A
IN
Other
Enumeration date
05/29/2014
Last updated
05/29/2014
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