| |
6614 Telegraph Rd, Bloomfield Hills, MI 48301-3012 | |
(248) 601-9207 | |
Not Available |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 6614 Telegraph Rd, Bloomfield Hills, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1124853841 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Joel Fredrickson |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1568812600 PECOS PAC ID: 9032402771 Enrollment ID: I20211103001993 |
Mailing Address | Practice Location Address |
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1773 Star Batt Dr, Rochester Hills, MI 48309-3708 Ph: (248) 601-9207 | 6614 Telegraph Rd, Bloomfield Hills, MI 48301-3012 Ph: (248) 601-9207 |