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General NPI Number Information
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NPI Number | 1710208772
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Entity Type | Individual
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Provider Name | NICOLE M. HATFIELD LPTA
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Gender | Female
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Dates
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Enumeration Date | 06/14/2010
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Last Update Date | 02/12/2011
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Provider Practice Location Address
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Address Line | 8380 GEDDES RD
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City | YPSILANTI
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State | MI
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Zip | 48198-9404
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Country | US
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Telephone | 734-547-7626
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Fax |
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Provider Business Mailing Address
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Address Line | 7849 COLLIN CT
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City | YPSILANTI
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State | MI
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Zip | 48197-1863
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Country | US
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Telephone | 734-340-3559
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 06001846A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 5502001719
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License Number State | MI
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