Individual
DR. JUSTIN NICHOLAS VICTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
2900 CHARLEVOIX DR SE, #200, GRAND RAPIDS, MI 49546-7085
(616) 975-5000
Mailing address
15285 OCEANA AVE, ALLEN PARK, MI 48101-1955
(313) 587-0812
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501016888
MI
225100000X
Physical Therapist
Primary
PT60747438
WA
Other
Enumeration date
08/27/2014
Last updated
08/07/2019
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