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General NPI Number Information
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NPI Number | 1346952223
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Entity Type | Individual
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Provider Name | FELLIPE MIKAMI DPT
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Gender | Male
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Dates
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Enumeration Date | 12/22/2022
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Last Update Date | 02/28/2024
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Provider Practice Location Address
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Address Line | 2771 OAK VALLEY DR
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City | ANN ARBOR
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State | MI
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Zip | 48103-9244
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Country | US
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Telephone | 734-821-7500
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Fax | 734-821-7501
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Provider Business Mailing Address
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Address Line | 33900 HARPER AVE STE 104
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48035-4258
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Country | US
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Telephone | 586-350-2644
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Fax | 586-541-3735
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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 | 5501301996
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License Number State | MI
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