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General NPI Number Information
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NPI Number | 1104769561
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Entity Type | Organization
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Legal Business Name | MICARE MGMT LLC
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Dates
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Enumeration Date | 04/10/2026
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Last Update Date | 04/10/2026
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Provider Practice Location Address
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Address Line | 44125 FORD RD
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City | CANTON
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State | MI
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Zip | 48187-3174
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Country | US
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Telephone | 248-891-5491
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Fax |
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Provider Business Mailing Address
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Address Line | 44125 FORD RD
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City | CANTON
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State | MI
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Zip | 48187-3174
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN PUTNAM
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Credential | DPT
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Telephone | 248-891-5491
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number |
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License Number State |
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