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General NPI Number Information
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NPI Number | 1316757446
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Entity Type | Organization
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Legal Business Name | MICHIGAN HEALTHCARE PROFESSIONALS, P.C.
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 6815 DIXIE HWY STE 3
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City | CLARKSTON
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State | MI
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Zip | 48346-2092
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Country | US
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Telephone | 248-384-8300
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Fax | 248-384-8301
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Provider Business Mailing Address
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Address Line | 30000 NORTHWESTERN HWY
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-3227
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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 | ADMIN ASSISTANT
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Name | KELSEY ROLA
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Credential | ADMIN
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Telephone | 248-922-2683
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251S0007X
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Taxonomy Name | Sports Physical Therapist
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License Number |
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License Number State |
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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 |
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