Individual
MR. AJAY MATHEW
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
303 N HURSTBOURNE PKWY, SUITE 200, LOUISVILLE, KY 40222-5185
(502) 412-5847
Mailing address
53755 BALDWIN CT, SHELBY TOWNSHIP, MI 48315-1666
(586) 232-4298
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502003619
MI
Other
Enumeration date
05/28/2013
Last updated
05/28/2013
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