Provider Demographics
NPI:1952552366
Name:RAMACHANDRAN, UMADEVI (RPT)
Entity Type:Individual
Prefix:
First Name:UMADEVI
Middle Name:
Last Name:RAMACHANDRAN
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15804 GARRISON LN
Mailing Address - Street 2:
Mailing Address - City:SOUTHGATE
Mailing Address - State:MI
Mailing Address - Zip Code:48195-3447
Mailing Address - Country:US
Mailing Address - Phone:734-925-1527
Mailing Address - Fax:734-281-1117
Practice Address - Street 1:7312 PARK AVE
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-1903
Practice Address - Country:US
Practice Address - Phone:734-925-1527
Practice Address - Fax:734-281-1117
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-03
Last Update Date:2008-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007790225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist