Healthcare Provider Details

I. General information

NPI: 1265073589
Provider Name (Legal Business Name): BRADLEY R STEGMEYER DPT, PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2019
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8896 COMMERCE RD STE 1
COMMERCE TOWNSHIP MI
48382-4494
US

IV. Provider business mailing address

9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US

V. Phone/Fax

Practice location:
  • Phone: 248-363-2115
  • Fax: 248-363-2308
Mailing address:
  • Phone: 248-363-2115
  • Fax: 248-363-2308

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501019350
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: