Individual
JUSTIN BATES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
2630 E JEFFERSON AVE, DETROIT, MI 48207-4129
(313) 259-7990
Mailing address
3840 COUSINO RD, ERIE, MI 48133-9754
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501020049
MI
Other
Enumeration date
06/11/2021
Last updated
06/11/2021
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