Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jan 6, 2009
License(s)
006853 (CT), 5501016463 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 21700 NORTHWESTERN HWY | Southfield, MI 48075-4906 | 248-798-3293 |
| LOCATION | 35501 MOUND RD | Sterling Heights, MI 48310-4724 | 248-798-3293 |
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