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Individual

BENJAMIN MCNULTY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OTD, OTRL

Contact information

Practice address
22731 NEWMAN ST STE 100B, DEARBORN, MI 48124-2023
(313) 791-0616
(313) 791-0632
Mailing address
253 SELKIRK ST, CANTON, MI 48187-3927
(734) 751-7969

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201013755
MI

Other

Enumeration date
01/23/2024
Last updated
01/23/2024
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