Provider Demographics
NPI:1013293042
Name:THOMAS, RONY CHARUVIL
Entity Type:Individual
Prefix:
First Name:RONY
Middle Name:CHARUVIL
Last Name:THOMAS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:RONY
Other - Middle Name:CHARUVIL
Other - Last Name:KURUVILLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35450 DEQUINDRE RD
Mailing Address - Street 2:SUITE 106
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4810
Mailing Address - Country:US
Mailing Address - Phone:248-835-9506
Mailing Address - Fax:
Practice Address - Street 1:35450 DEQUINDRE RD
Practice Address - Street 2:SUITE 106
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4810
Practice Address - Country:US
Practice Address - Phone:248-835-9506
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-21
Last Update Date:2012-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014058225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist