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General NPI Number Information
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NPI Number | 1790176550
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Entity Type | Individual
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Provider Name | JIGNESH CHABHADIYA
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Gender | Male
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Dates
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Enumeration Date | 02/13/2015
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Last Update Date | 02/13/2015
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Provider Practice Location Address
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Address Line | 12837 BAY TREE WAY
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City | LOUISVILLE
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State | KY
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Zip | 40245-6536
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Country | US
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Telephone | 248-979-0161
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Fax |
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Provider Business Mailing Address
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Address Line | 12837 BAY TREE WAY
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City | LOUISVILLE
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State | KY
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Zip | 40245-6536
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Country | US
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Telephone | 248-979-0161
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1214149
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501014880
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 05011662A
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License Number State | IN
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 005966
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License Number State | KY
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