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Individual

SHYNU VARGHESE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
17066 BOULDER DR, NORTHVILLE, MI 48168-6820
(832) 419-5350
Mailing address
17066 BOULDER DR, NORTHVILLE, MI 48168-6820
(832) 419-5350

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
009621
NY

Other

Enumeration date
09/26/2016
Last updated
09/26/2016
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