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General NPI Number Information
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NPI Number | 1366322646
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Entity Type | Individual
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Provider Name | IRELYN ANKENBAUER DPT
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Gender | Female
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Dates
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Enumeration Date | 09/05/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 43050 FORD RD STE 100
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City | CANTON
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State | MI
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Zip | 48187-3374
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Country | US
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Telephone | 734-844-9130
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Fax |
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Provider Business Mailing Address
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Address Line | 46222 BRITTANIA LN UNIT 24
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City | CANTON
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State | MI
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Zip | 48187-6617
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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 |
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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 |
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License Number State | MI
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