Healthcare Provider Details

I. General information

NPI: 1720226467
Provider Name (Legal Business Name): DINA ANN HOBAN PTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/03/2009
Last Update Date: 02/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35746 HARPER AVE
CLINTON TWP MI
48035-3212
US

IV. Provider business mailing address

383 N MAIN ST
ROMEO MI
48065-4623
US

V. Phone/Fax

Practice location:
  • Phone: 586-791-9203
  • Fax: 586-791-9204
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: