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NPI 1548317688

NPI 1548317688 : ERIC JOSEPH VANHULLE PT MPT OMPT CSCS : WARREN, MI

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General NPI Number Information
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    NPI Number           |    1548317688
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    Entity Type          |    Individual 
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    Provider Name        |    ERIC JOSEPH VANHULLE PT MPT OMPT CSCS
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    01/04/2007
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    Last Update Date     |    02/03/2025
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Provider Practice Location Address
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    Address Line         |    13850 E 12 MILE RD # 2A 
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    City                 |    WARREN
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    State                |    MI
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    Zip                  |    48088-3730
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    Country              |    US
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    Telephone            |    586-445-3945
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    Fax                  |    586-350-2011
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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 TWP
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    State                |    MI
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    Zip                  |    48035-4258
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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        |    2251X0800X
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    Taxonomy Name        |    Orthopedic Physical Therapist
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    License Number       |    5501010847
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    License Number State |    MI
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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       |    5501010847
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    License Number State |    MI
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