Provider Demographics
NPI:1437486859
Name:RAVARY, JOSH MICHAEL (PTA)
Entity Type:Individual
Prefix:
First Name:JOSH
Middle Name:MICHAEL
Last Name:RAVARY
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2962 DIXIEBROOK
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:MI
Mailing Address - Zip Code:48133
Mailing Address - Country:US
Mailing Address - Phone:734-652-1903
Mailing Address - Fax:
Practice Address - Street 1:610 W ELM AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-7909
Practice Address - Country:US
Practice Address - Phone:734-240-9670
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-05
Last Update Date:2013-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant