Healthcare Provider Details

I. General information

NPI: 1578895983
Provider Name (Legal Business Name): JAMES EDGAR SEARCY JR. P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3890 PRESCOTT ST
HAMTRAMCK MI
48212-3116
US

IV. Provider business mailing address

3890 PRESCOTT ST
HAMTRAMCK MI
48212-3116
US

V. Phone/Fax

Practice location:
  • Phone: 313-892-9437
  • Fax:
Mailing address:
  • Phone: 313-892-9437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501009766
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: