| Doctor Name: | MR. BRADLEY EDWARD PUTVIN |
| NPI Number: | 1609035450 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | 5501001469 |
| Business Practice Address: | 5889 Whitmore Lake Rd Suite C Brighton, MI - 481161998 |
| Business Phone Number: | 8102297931 |
| Business Fax Number: | 8102297935 |
| Mailing Address: | 27733 Schoenherr Rd, WARREN |
| State: | MI |
| Postal Code: | 480886641 |
| Phone Number: | 8109232361 |
| Fax Number: | 5864276642 |
| NPI Enumeration Date: | 06/06/2008 |
| NPI Last Update Date: | 01/06/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501001469 |
| 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 |