Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jan 16, 2023
License(s)
5501302226 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 3601 W 13 MILE RD | Royal Oak, MI 48073-6712 | 248-898-0190 |
| MAILING | 7651 MIDDLEPOINTE ST | Dearborn, MI 48126-1235 |
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