Ajay Mathew PTA

NPI 1497192686 - Physical Therapy Assistant - 225200000X

NPI Details
NPI 1497192686
Gender Male
Enumeration Date 05/28/2013
Last Updated 05/28/2013
Entity Type Individual
Active Over 3 years ago
Practice Location
303 N HURSTBOURNE PKWY
SUITE 200
LOUISVILLE KY, 40222-5185, US
Phone (502) 412-5847
Fax
Business Location
53755 BALDWIN CT
SHELBY TOWNSHIP MI, 48315-1666, US
Phone (586) 232-4298
Fax
Toxanomy
Taxonomy Code 225200000X
License State Michigan
License Number 5502003619
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According to our database, Mr. Ajay Mathew PTA NPI is 1497192686, taxonomy code is 225200000X and license number is 5502003619, license state is located at Michigan. Ajay Mathew PTA physically located at 303 N Hurstbourne Pkwy, Louisville KY, 40222-5185. NPI Number Ajay Mathew PTA has the Individual type.

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1497192686 NPI number is provided on an as is basis without warranty of any kind. 1497192686 is maintained by the National Plan & Provider Enumeration System. The contents of Ajay Mathew PTA are for informational purposes only.