Healthcare Provider Details

I. General information

NPI: 1285892216
Provider Name (Legal Business Name): PAUL HOWARD BILKY PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2008
Last Update Date: 05/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1805 W PYLE DR
KINGSFORD MI
49802-4258
US

IV. Provider business mailing address

1805 W PYLE DR
KINGSFORD MI
49802-4258
US

V. Phone/Fax

Practice location:
  • Phone: 906-774-1530
  • Fax: 906-779-1296
Mailing address:
  • Phone: 906-774-1530
  • Fax: 906-779-1296

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: