Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 5501002351 | MI |
N | 2251H1200X | Hand | 9511000285 | MI |
NPI | 1780075036 |
---|---|
Provider Name | David Stolarski |
First Address | Ypsilanti, MI 48197-1120 |
Second Address | Ypsilanti, MI 48197-1120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/02/2015 |
Last Update Date | 09/02/2015 |