Healthcare Provider Details

I. General information

NPI: 1447523295
Provider Name (Legal Business Name): BRIAN STEVEN GILHOOL DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/09/2012
Last Update Date: 02/09/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3009 S BALDWIN RD
ORION MI
48359-2362
US

IV. Provider business mailing address

878 S ROCHESTER RD
ROCHESTER HILLS MI
48307-2767
US

V. Phone/Fax

Practice location:
  • Phone: 248-393-7707
  • Fax: 248-393-7708
Mailing address:
  • Phone: 248-601-9207
  • Fax: 248-650-8670

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501015828
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: