Individual
MR. ELIJA KAMAL SANSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.P.T.
Contact information
Practice address
8381 E 12 MILE RD, WARREN, MI 48093-2769
(586) 698-1999
(586) 576-6531
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
(866) 370-8206
(517) 435-3670
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010471
MI
Other
Enumeration date
05/24/2007
Last updated
07/11/2023
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