MEDICARE: PATRICIA FLATLEY

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	225100000X	Physical Therapist		MI

General Provider Information

NPI Number	:	1639351620
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA FLATLEY

Provider Business Mailing Address
First Line	:	12348 WHITE TAIL CT
Second Line	:
City	:	PLYMOUTH
State	:	MI
Zip	:	48170-2875
Country	:	US
Telephone Number	:	734-276-9098
Fax Number	:

Provider Business Practice Location Address
First Line	:	19701 VERNIER RD
Second Line	:	SUITE280
City	:	HARPER WOODS
State	:	MI
Zip	:	48225-1467
Country	:	US
Telephone Number	:	313-884-8920
Fax Number	:

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

Provider Enumeration Date	:	11/30/2007
Last Update Date	:	11/30/2007

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Directions to “ PATRICIA FLATLEY ” Practice Location

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