| Doctor Name: | PAMELA BRIOSO GONZALES-LANAC |
| NPI Number: | 1003070632 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPT |
| License Number: | 5501012837 |
| Business Practice Address: | 4600 E 14 Mile Rd Suite 3 Warren, MI - 480924369 |
| Business Phone Number: | 8663353255 |
| Business Fax Number: | 5866012500 |
| Mailing Address: | 4600 E 14 Mile Rd, Suite 3 WARREN |
| State: | MI |
| Postal Code: | 480924369 |
| Phone Number: | 8663353255 |
| Fax Number: | 5866012500 |
| NPI Enumeration Date: | 07/14/2008 |
| NPI Last Update Date: | 07/14/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501012837 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |