Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation | 5201010523 | MI |
NPI | 1538775325 |
---|---|
Provider Name | Adam L Hardy |
First Address | Royal Oak, MI 48073-6712 |
Second Address | Royal Oak, MI 48073-6712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/09/2020 |
Last Update Date | 17/09/2020 |