Healthcare Provider Details

I. General information

NPI: 1548317688
Provider Name (Legal Business Name): ERIC JOSEPH VANHULLE PT MPT OMPT CSCS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13850 E 12 MILE RD # 2A
WARREN MI
48088-3730
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 586-445-3945
  • Fax: 586-350-2011
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501010847
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: