Individual
JOSE CYRIAC CHAZHIKAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Contact information
Practice address
345 E 8 MILE RD, HAZEL PARK, MI 48030-2546
(248) 291-5534
(248) 291-5536
Mailing address
345 E 8 MILE RD, HAZEL PARK, MI 48030-2546
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010693
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26-2191246
TAX ID #
MI
Enumeration date
03/15/2012
Last updated
03/16/2012
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