Individual
MRS. ELAINE MARIE SOUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTRL, CHT
Contact information
Practice address
29525 FORD RD, GARDEN CITY, MI 48135-2319
(734) 522-0065
Mailing address
9368 N LILLEY RD, PLYMOUTH, MI 48170-4610
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
5201000641
MI
Other
Enumeration date
06/11/2018
Last updated
02/25/2020
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