Basic Information
| Provider Information | |||||||||
| NPI: | 1538451265 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VYAS | ||||||||
| FirstName: | PARESHKUMAR | ||||||||
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| Credential: | PT | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2125 E 14 MILE RD | ||||||||
| Address2: | APT 201 | ||||||||
| City: | STERLING HEIGHTS | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483105922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2489065160 | ||||||||
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| Practice Location | |||||||||
| Address1: | 5130 COOLIDGE HWY | ||||||||
| Address2: | |||||||||
| City: | ROYAL OAK | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480731001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2484357400 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/13/2011 | ||||||||
| LastUpdateDate: | 05/13/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 5501014110 | MI | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.