MEDICARE: MR. PAUL HOWARD BILKY PTA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225200000X	Physical Therapy Assistant

General Provider Information

NPI Number	:	1285892216
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PAUL HOWARD BILKY PTA

Provider Business Mailing Address
First Line	:	1805 W PYLE DR
Second Line	:
City	:	KINGSFORD
State	:	MI
Zip	:	49802-4258
Country	:	US
Telephone Number	:	906-774-1530
Fax Number	:	906-779-1296

Provider Business Practice Location Address
First Line	:	1805 W PYLE DR
Second Line	:
City	:	KINGSFORD
State	:	MI
Zip	:	49802-4258
Country	:	US
Telephone Number	:	906-774-1530
Fax Number	:	906-779-1296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/27/2008
Last Update Date	:	05/27/2008

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