Individual
DIVIYA BHARATHI RAVIKUMAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
Mailing address
205 N EAST AVE, JACKSON, MI 49201-1753
(517) 205-4800
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
05/01/2026
Last updated
05/01/2026
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