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General NPI Number Information
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NPI Number | 1952377244
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Entity Type | Individual
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Provider Name | ELIZABETH ANN PERUSKI D.P.T., A.T.C.
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Gender | Female
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Dates
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Enumeration Date | 02/27/2006
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Last Update Date | 03/29/2009
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Provider Practice Location Address
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Address Line | 53 S WASHINGTON ST
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City | OXFORD
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State | MI
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Zip | 48371-6433
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Country | US
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Telephone | 248-236-0035
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Fax | 248-236-0125
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Provider Business Mailing Address
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Address Line | 878 S ROCHESTER RD
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-2740
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Country | US
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Telephone | 248-236-0035
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Fax | 248-236-0035
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 5501012728
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License Number State | MI
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