Doctor Name: | EBRAM M FANOUS |
NPI Number: | 1053502468 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT |
License Number: | 5501011728 |
Business Practice Address: | 134 W University Dr Ste 103 Rochester, MI - 483071951 |
Business Phone Number: | 2486501984 |
Business Fax Number: | 2486501994 |
Mailing Address: | 134 W University Dr Ste 103, ROCHESTER |
State: | MI |
Postal Code: | 483071951 |
Phone Number: | 2486501984 |
Fax Number: | 2486501994 |
NPI Enumeration Date: | 08/09/2007 |
NPI Last Update Date: | 08/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501011728 |
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 |