Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist | MI |
NPI | 1255875779 |
---|---|
Provider Name | Julie Levinson |
First Address | West Bloomfield, MI 48322-2822 |
Second Address | West Bloomfield, MI 48322-3013 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/12/2016 |
Last Update Date | 19/12/2016 |