Healthcare Provider Details

I. General information

NPI: 1568653814
Provider Name (Legal Business Name): DAVID GEORGE HUTCHINSON P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/01/2007
Last Update Date: 08/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29703 HOOVER RD STE A
WARREN MI
48093-8901
US

IV. Provider business mailing address

2430 EMERSON AVE
BLOOMFIELD HILLS MI
48302-0433
US

V. Phone/Fax

Practice location:
  • Phone: 586-582-0340
  • Fax:
Mailing address:
  • Phone: 248-334-5495
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1995973
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: