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General NPI Number Information
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NPI Number | 1053500173
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Entity Type | Individual
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Provider Name | ANEMAECORE ABADEJOS BRODITH PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 10/15/2007
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Last Update Date | 01/31/2023
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Provider Practice Location Address
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Address Line | 26000 HOOVER RD STE 101
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City | WARREN
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State | MI
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Zip | 48089
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Country | US
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Telephone | 586-381-8141
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Fax | 586-393-1733
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Provider Business Mailing Address
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Address Line | 23240 WESTBURY ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-2549
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Country | US
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Telephone | 313-478-1182
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501004528
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State | CA
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