Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Revanth Mopuru

Individual provider Physical Therapist · NPI 1114371275

Revanth Mopuru is a Physical Therapist in East Lansing, Michigan. Practices as a sole proprietor. Licensed in Michigan.

Licensed in
MI
In the registry since
2016

Practice location Address checks out

2815 Northwind Dr
East Lansing, MI 48823-5003
Phone: (517) 332-0817
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 5501013417 (MI)

Record details

NPI number1114371275
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorYes
NPI enumeratedApril 14, 2016
Last updated in NPPESApril 14, 2016

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