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General NPI Number Information
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NPI Number | 1831673524
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Entity Type | Individual
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Provider Name | SAMUEL APPLE DPT
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Gender | Male
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 09/19/2018
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Provider Practice Location Address
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Address Line | 455 E GRAND RIVER AVE STE 102
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City | BRIGHTON
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State | MI
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Zip | 48116-1563
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Country | US
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Telephone | 810-534-7004
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Fax | 810-775-1046
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Provider Business Mailing Address
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Address Line | 6156 RICHARDS
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City | BRIGHTON
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State | MI
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Zip | 48116-9548
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Country | US
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Telephone | 810-599-6314
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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 | 5501018914
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License Number State | MI
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