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NPI Code Detail

MEDICARE: MRS. RUTH HOSKINS-DWIGHT PT

MEDICARE: MRS. RUTH HOSKINS-DWIGHT PT
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
1225100000XPhysical Therapist5501001363MI

General Provider Information

NPI Number : 1720099880
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. RUTH HOSKINS-DWIGHT PT
Provider Business Mailing Address
First Line : 42615 GARFIELD ROAD
Second Line :
City : CLINTON TOWNSHIP
State : MI
Zip : 48038
Country : US
Telephone Number : 586-412-2846
Fax Number : 586-412-7087
Provider Business Practice Location Address
First Line : 1432 E 12 MILE RD
Second Line :
City : MADISON HEIGHTS
State : MI
Zip : 48071-2651
Country : US
Telephone Number : 586-412-2846
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 07/08/2007

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