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Individual

ANNA BERTRAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PTA

Contact information

Practice address
22180 PONTIAC TRL STE E, SOUTH LYON, MI 48178-9097
(248) 446-0155
(248) 446-0177
Mailing address
22180 PONTIAC TRL STE E, SOUTH LYON, MI 48178-9097
(248) 446-0155
(248) 446-0177

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005970
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5502005970
PTA LICENSE NUMBER
MI
Enumeration date
03/18/2024
Last updated
03/18/2024
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