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Gerald Lee Philo Jr., PTA

Physical Therapy Assistant in Dearborn, MI. Individual provider (NPI-1).

NPI number1962087262
StatusActive
Last updated in NPPESMar 24, 2021

Details

NPI
1962087262
Entity type
Individual (NPI-1)
Name
Gerald Lee Philo Jr.
Credential
PTA
Sex
Male
Sole proprietor
Yes
Enumeration date
Mar 17, 2021
Certification date
Mar 24, 2021
Last updated
Mar 24, 2021

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225200000X Physical Therapy Assistant5502000079MIYes

Practice location

5500 Auto Club Dr Ste 150
Dearborn, MI 48126-2779

Phone 313-982-8266 · Fax 313-982-8098

Mailing address

5500 Auto Club Dr Ste 150
Dearborn, MI 48126-2779

Phone 313-982-8266 · Fax 313-982-8098

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