Provider Demographics
NPI:1619113594
Name:CHATLA, NOEL SUDARSAN (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:NOEL
Middle Name:SUDARSAN
Last Name:CHATLA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:905 N MACOMB ST STE 3
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-3076
Mailing Address - Country:US
Mailing Address - Phone:734-241-0560
Mailing Address - Fax:734-241-3230
Practice Address - Street 1:905 N MACOMB ST STE 3
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-3076
Practice Address - Country:US
Practice Address - Phone:734-241-0560
Practice Address - Fax:734-241-3230
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-26
Last Update Date:2023-12-07
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MIL14095412081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine