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General NPI Number Information
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NPI Number | 1124423652
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Entity Type | Individual
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Provider Name | JANNA WEEKHOUT P.T.
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Gender | Female
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Dates
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Enumeration Date | 10/27/2014
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Last Update Date | 10/27/2014
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Provider Practice Location Address
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Address Line | 14153 RICK DR
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48315-2951
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Country | US
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Telephone | 586-566-0326
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Fax |
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Provider Business Mailing Address
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Address Line | 61606 WOODFIELD WAY
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City | WASHINGTON
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State | MI
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Zip | 48094-1538
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Country | US
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Telephone | 586-243-7392
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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 | 5501004075
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License Number State | MI
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