Organization
EDUARDO A. ENRIQUEZ, P T PC
Active
Other names
Milan Physical Therapy
Organization subpart
No
Provider details
NPI number
Authorized official
EDUARDO ALBERTO ENRIQUEZ PT (PHYSICAL THERAPIST/ OWNER)
(734) 439-8410
Entity
Organization
Contact information
Practice address
905 DEXTER ST, MILAN, MI 48160-1160
(734) 439-8410
(734) 439-8430
Mailing address
905 DEXTER ST, MILAN, MI 48160-1160
(734) 439-8410
(734) 439-8430
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
225100000X
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10425482410
—
MI
01
—
16866
MCARE PIN NUMBER
MI
01
—
650D657010
BLUE CROSS PROVIDER CODE
MI
Enumeration date
06/02/2006
Last updated
10/08/2014
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