Individual
CHAKA MATHIEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
11554 E 12 MILE RD, WARREN, MI 48093-2644
(586) 558-0185
(586) 558-7128
Mailing address
23228 GRAYSON DR, SOUTHFIELD, MI 48075-3690
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501005265
MI
Other
Enumeration date
05/23/2007
Last updated
07/08/2007
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