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1275681793
LISA DECONINCK
TROY, MI
NPI
1275681793
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501008619)
Enumeration Date
2007-01-08
Last Update Date
2007-07-08
Business Address
-- LISA DECONINCK MPT
1845 LIVERNOIS
TROY, MI 48083
Phone number: 248-362-2150
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Mailing Address
-- LISA DECONINCK MPT
1980 HILLWOOD CT
BLOOMFIELD HILLS, MI 48304
Phone number: 248-646-1916
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