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General NPI Number Information
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NPI Number | 1427015148
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Entity Type | Individual
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Provider Name | NOELLE CHRISTI FENSKE M.S, P.T, C.M.P.T.
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Gender | Female
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Dates
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Enumeration Date | 04/27/2006
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Last Update Date | 03/08/2011
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Provider Practice Location Address
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Address Line | 16200 19 MILE
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City | CLINTON TWP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-416-2065
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Fax | 586-228-7159
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Provider Business Mailing Address
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Address Line | 16200 19 MILE BOX 380713 MACOMB OAKLAND REGIONAL CNT.
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City | CLINTON TWP
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State | MI
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Zip | 48038
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Country | US
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Telephone | 586-416-2065
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Fax | 586-228-7159
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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 | 5501011411
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License Number State | MI
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