| Doctor Name: | MR. MAHESH KUMAR KODIKALLA SRINIVASULU |
| NPI Number: | 1013295757 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.P.T. |
| License Number: | 2305206617 |
| Business Practice Address: | 7612 Timberlake Rd Apt # 735 Lynchburg, VA - 245022354 |
| Business Phone Number: | 5173153347 |
| Business Fax Number: | |
| Mailing Address: | 7612 Timberlake Road, Apt # 735 LYNCHBURG |
| State: | VA |
| Postal Code: | 245022467 |
| Phone Number: | 5173153347 |
| Fax Number: | |
| NPI Enumeration Date: | 07/29/2011 |
| NPI Last Update Date: | 07/29/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 2305206617 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | VA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |