| Doctor Name: | MR. RAVIKUMAR K SHUKLA |
| NPI Number: | 1356677835 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | RPT |
| License Number: | 5501013597 |
| Business Practice Address: | 751 Kenmoor Ave Se Suite # E Grand Rapids, MI - 495462388 |
| Business Phone Number: | 6169547013 |
| Business Fax Number: | 6169547014 |
| Mailing Address: | 5511 W Us Highway 10, Suite # B LUDINGTON |
| State: | MI |
| Postal Code: | 494312455 |
| Phone Number: | 2318450900 |
| Fax Number: | 2318450909 |
| NPI Enumeration Date: | 10/19/2009 |
| NPI Last Update Date: | 03/10/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501013597 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| 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 |