MEDICARE: KAMERON MUELLER

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	225200000X	Physical Therapy Assistant	CP058374A	MD
2	225200000X	Physical Therapy Assistant	PTA013868	OH

General Provider Information

NPI Number	:	1659205417
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAMERON MUELLER

Provider Business Mailing Address
First Line	:	39111 6 MILE RD
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-3909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	39111 6 MILE RD
Second Line	:
City	:	LIVONIA
State	:	MI
Zip	:	48152-3909
Country	:	US
Telephone Number	:	866-991-0900
Fax Number	:

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

Provider Enumeration Date	:	06/09/2026
Last Update Date	:	06/09/2026

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Directions to “ KAMERON MUELLER ” Practice Location

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