Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 5501017876 | MI |
NPI | 1760985170 |
---|---|
Provider Name | Ashley Peczynski |
First Address | Plymouth, MI 48170-1827 |
Second Address | Novi, MI 48377-3600 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/03/2018 |
Last Update Date | 24/03/2021 |