Provider Demographics
NPI:1891078218
Name:GHEEWALA, HIRAL PARESH
Entity Type:Individual
Prefix:
First Name:HIRAL
Middle Name:PARESH
Last Name:GHEEWALA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2131 N LOVINGTON DR
Mailing Address - Street 2:APT # 208
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4354
Mailing Address - Country:US
Mailing Address - Phone:630-917-7424
Mailing Address - Fax:
Practice Address - Street 1:15636 SOUTHFIELD RD
Practice Address - Street 2:
Practice Address - City:ALLEN PARK
Practice Address - State:MI
Practice Address - Zip Code:48101-2513
Practice Address - Country:US
Practice Address - Phone:313-928-0700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-21
Last Update Date:2011-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015162225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist