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General NPI Number Information
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NPI Number | 1942845581
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Entity Type | Individual
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Provider Name | ALICIA ANN GILLMAN WARRICK DPT
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Gender | Female
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Dates
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Enumeration Date | 11/07/2019
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Last Update Date | 11/07/2019
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Provider Practice Location Address
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Address Line | 10483 DIXIE HWY
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City | HOLLY
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State | MI
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Zip | 48442-9311
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Country | US
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Telephone | 810-771-7686
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Fax |
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Provider Business Mailing Address
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Address Line | 2109 THORNRIDGE DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-8993
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Country | US
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Telephone | 989-630-7535
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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 | 5501019399
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License Number State | MI
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