Individual
ERICK FOUNTAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
21384 PINE CONE DR, MACOMB, MI 48042-4335
(586) 949-5334
Mailing address
21384 PINE CONE DR, MACOMB, MI 48042-4335
(586) 949-5334
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501010159
MI
Other
Enumeration date
10/12/2007
Last updated
10/12/2007
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