| Doctor Name: | MR. JIMS THANKACHAN VARGHESE |
| NPI Number: | 1063722676 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T. |
| License Number: | 5501014403 |
| Business Practice Address: | 800 W Long Lake Rd Ste 103 Bloomfield Hills, MI - 483022033 |
| Business Phone Number: | 2482800900 |
| Business Fax Number: | 2482828416 |
| Mailing Address: | 800 W Long Lake Rd, Ste 103 BLOOMFIELD HILLS |
| State: | MI |
| Postal Code: | 483022033 |
| Phone Number: | 2484800900 |
| Fax Number: | 2482828416 |
| NPI Enumeration Date: | 10/15/2010 |
| NPI Last Update Date: | 01/05/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501014403 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |