Individual
MRS. CONNIE LEE EILAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
3645 CHATSWORTH ST, DETROIT, MI 48224-3447
(313) 343-8808
(313) 343-8862
Mailing address
3645 CHATSWORTH ST, DETROIT, MI 48224-3447
(313) 343-8808
(313) 343-8862
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5501000692
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501000692
PHYSICAL THERAPY LICENSE
MI
Enumeration date
02/28/2007
Last updated
07/08/2007
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