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General NPI Number Information
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NPI Number | 1710886742
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Entity Type | Individual
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Provider Name | EVAN CAMERON MCBRIDE PT, DPT, LMT
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Gender | Male
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Dates
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Enumeration Date | 11/04/2026
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Last Update Date | 11/04/2026
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Provider Practice Location Address
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Address Line | 9171 LAPEER RD STE 400
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City | DAVISON
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State | MI
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Zip | 48423-1849
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Country | US
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Telephone | 810-653-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 24305 THORNRIDGE DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-9276
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Country | US
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Telephone | 419-573-9521
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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 | 5501304794
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License Number State | MI
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