Individual
JIM ZIVAN TAVRAZICH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
22777 W 11 MILE RD FL PT2, SOUTHFIELD, MI 48033-2152
(248) 386-5270
Mailing address
2762 BRADY DR, BLOOMFIELD TOWNSHIP, MI 48304-1725
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501002600
MI
Other
Enumeration date
03/01/2018
Last updated
03/30/2021
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