Basic Information
| Provider Information | |||||||||
| NPI: | 1154775237 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EAPPAKKAM KUMARASWAMY | ||||||||
| FirstName: | PARTHASARATHY | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4405 HERITAGE AVE | ||||||||
| Address2: | 1B | ||||||||
| City: | OKEMOS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488643324 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173485155 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1843 N HAGADORN RD | ||||||||
| Address2: | |||||||||
| City: | EAST LANSING | ||||||||
| State: | MI | ||||||||
| PostalCode: | 488232229 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5173325061 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/14/2016 | ||||||||
| LastUpdateDate: | 04/14/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501015572 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.