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NPI Code Detail

MEDICARE: DR. KELLY ANN APOSTOLOVSKI D.P.T.

MEDICARE: DR. KELLY ANN APOSTOLOVSKI D.P.T.
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
1225100000XPhysical Therapist5501011852MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130647OTHERMIBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1962506352
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KELLY ANN APOSTOLOVSKI D.P.T.
Provider Business Mailing Address
First Line : 3240 W SILVER LAKE RD
Second Line :
City : FENTON
State : MI
Zip : 48430-1374
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3240 W SILVER LAKE RD
Second Line :
City : FENTON
State : MI
Zip : 48430-1374
Country : US
Telephone Number : 810-714-4616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/07/2006
Last Update Date : 06/18/2009

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