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General NPI Number Information
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NPI Number | 1558863365
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Entity Type | Individual
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Provider Name | JOCELYN CARTUJANO BAISA PT
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Gender | Female
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Dates
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Enumeration Date | 03/07/2018
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Last Update Date | 03/07/2018
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Provider Practice Location Address
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Address Line | 47601 GRAND RIVER AVE
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City | NOVI
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State | MI
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Zip | 48374-1233
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Country | US
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Telephone | 248-465-5800
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Fax | 248-465-4686
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Provider Business Mailing Address
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Address Line | 743 BINGHAM CT
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City | COMMERCE TWP
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State | MI
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Zip | 48382-5012
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Country | US
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Telephone | 734-771-8394
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Fax | 248-465-4686
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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 |
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