| Doctor Name: | JOHN FONTAINE |
| NPI Number: | 1730546508 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 5501017557 |
| Business Practice Address: | 33900 Harper Ave Suite 104 Clinton Township, MI - 480354258 |
| Business Phone Number: | 5864169100 |
| Business Fax Number: | 5864169103 |
| Mailing Address: | 4245 W 14 Mile Rd, ROYAL OAK |
| State: | MI |
| Postal Code: | 480731501 |
| Phone Number: | 2485549201 |
| Fax Number: | 2485549202 |
| NPI Enumeration Date: | 01/25/2016 |
| NPI Last Update Date: | 01/25/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | 5501017557 |
| 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 |