Registry details
Type
Individual
Primary specialty
Physical Therapist
Enumerated
Jan 24, 2022
License(s)
12746 (MN), PT031688 (PA), 5501301887 (MI)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| MAILING | 26289 SHEAHAN DR | Dearborn Heights, MI 48127-4117 | 313-516-2475 |
| LOCATION | 31745 8 MILE RD | Livonia, MI 48152-1360 | 248-733-5052 |
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