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NPI Code Detail

MEDICARE: MR. JAY SHANKAR JHA PHYSICAL THERAPIST

MEDICARE: MR. JAY SHANKAR JHA PHYSICAL THERAPIST
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist5501006270MI

General Provider Information

NPI Number : 1760659460
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JAY SHANKAR JHA PHYSICAL THERAPIST
Provider Business Mailing Address
First Line : 10809 MACK AVE
Second Line : SUITE PT
City : DETROIT
State : MI
Zip : 48214-2119
Country : US
Telephone Number : 313-331-2100
Fax Number : 313-331-2101
Provider Business Practice Location Address
First Line : 10809 MACK AVE
Second Line : SUITE PT
City : DETROIT
State : MI
Zip : 48214-2119
Country : US
Telephone Number : 313-331-2100
Fax Number : 313-331-2101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/12/2008
Last Update Date : 05/12/2008

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Directions to “ MR. JAY SHANKAR JHA PHYSICAL THERAPIST” Practice Location

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