MEDICARE: JAIMIE HOWORTH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	300122	CA

General Provider Information

NPI Number	:	1417620899
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAIMIE HOWORTH

Provider Business Mailing Address
First Line	:	8308 MERRILL RD
Second Line	:
City	:	WHITMORE LAKE
State	:	MI
Zip	:	48189-9607
Country	:	US
Telephone Number	:	734-972-2994
Fax Number	:

Provider Business Practice Location Address
First Line	:	8308 MERRILL RD
Second Line	:
City	:	WHITMORE LAKE
State	:	MI
Zip	:	48189-9607
Country	:	US
Telephone Number	:	734-972-2994
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/30/2021
Last Update Date	:	07/30/2021

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Directions to “ JAIMIE HOWORTH ” Practice Location

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