Provider Demographics
NPI:1225531833
Name:NATARAJAN, MURALI (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:MURALI
Middle Name:
Last Name:NATARAJAN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4049 WOODRUSH LN NW
Mailing Address - Street 2:
Mailing Address - City:COMSTOCK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:49321-9360
Mailing Address - Country:US
Mailing Address - Phone:616-690-8918
Mailing Address - Fax:
Practice Address - Street 1:1401 CEDAR ST NE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49503-1375
Practice Address - Country:US
Practice Address - Phone:616-690-8918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-10
Last Update Date:2018-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005788225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist