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General NPI Number Information
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NPI Number | 1326708520
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Entity Type | Individual
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Provider Name | CASEY ALLISON HUNT PTA
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Gender | Female
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Dates
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Enumeration Date | 12/29/2021
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Last Update Date | 12/29/2021
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Provider Practice Location Address
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Address Line | 205 W GRAND RIVER AVE STE 201
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City | BRIGHTON
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State | MI
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Zip | 48116-1659
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Country | US
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Telephone | 810-588-4133
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Fax | 810-588-4124
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Provider Business Mailing Address
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Address Line | 11151 REDBERRY CT
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City | WHITMORE LAKE
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State | MI
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Zip | 48189-8290
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Country | US
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Telephone | 810-772-8833
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5502006347
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License Number State | MI
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