Doctor Name: | KRISTYN ANN IMESCH |
NPI Number: | 1477655132 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MSPT |
License Number: | 5501009543 |
Business Practice Address: | 24715 Little Mack Ave Suite 100 Saint Clair Shores, MI - 480803207 |
Business Phone Number: | 5867792585 |
Business Fax Number: | 5867797748 |
Mailing Address: | 283 Merriweather Rd, GROSSE POINTE FARMS |
State: | MI |
Postal Code: | 482363428 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 09/02/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 5501009543 |
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 |