Healthcare Provider Details

I. General information

NPI: 1497684468
Provider Name (Legal Business Name): EMMA BOND
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2026
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 4TH ST
WAYNE MI
48184-1358
US

IV. Provider business mailing address

3001 4TH ST
WAYNE MI
48184-1358
US

V. Phone/Fax

Practice location:
  • Phone: 734-377-9866
  • Fax:
Mailing address:
  • Phone: 734-377-9866
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: