| NPI | 1902165566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE JOHNSON Credentialing Manager 586-710-2307 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225200000X Physical Therapy Assistant (Licence: MI 5502000482) |
| Enumeration Date | 2012-05-16 |
| Last Update Date | 2025-05-22 |