Doctor Name: | COREY ADAM MCCUE |
NPI Number: | 1164891529 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PT, DPT |
License Number: | 5501017411 |
Business Practice Address: | 22180 Pontiac Trl Suite E South Lyon, MI - 481789097 |
Business Phone Number: | 2484460155 |
Business Fax Number: | 2484460177 |
Mailing Address: | 22180 Pontiac Trl E, SOUTH LYON |
State: | MI |
Postal Code: | 481789097 |
Phone Number: | 2484460155 |
Fax Number: | 2484460177 |
NPI Enumeration Date: | 09/16/2015 |
NPI Last Update Date: | 09/16/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501017411 |
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 |