Healthcare Provider Details

I. General information

NPI: 1558726281
Provider Name (Legal Business Name): ANNE BOREMA MS, OTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/23/2015
Last Update Date: 12/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3729 WEST ST
ANN ARBOR MI
48103-9438
US

IV. Provider business mailing address

3729 WEST ST
ANN ARBOR MI
48103-9438
US

V. Phone/Fax

Practice location:
  • Phone: 734-904-2832
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number5201009133
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: