Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | MI |
NPI | 1003495946 |
---|---|
Provider Name | Catherine Tomsich |
First Address | Warren, MI 48089-2000 |
Second Address | Warren, MI 48089-2076 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/04/2021 |
Last Update Date | 07/04/2021 |