Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1841762473 |
---|---|
Provider Name | Mr. Hunter Thomas Michaels |
First Address | Shelby Twp, MI 48316 |
Second Address | Troy, MI 48084 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/12/2018 |
Last Update Date | 20/12/2018 |