Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 5501017454 | MI |
NPI | 1023488962 |
---|---|
Provider Name | Seth King |
First Address | Rochester Hills, MI 48309-3667 |
Second Address | Rochester Hills, MI 48309-3722 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2015 |
Last Update Date | 01/04/2020 |