Individual
MR. MASASHI MIZOBUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
1663 STEPHENSON HWY, TROY, MI 48083-2169
(248) 327-6619
Mailing address
1663 STEPHENSON HWY, TROY, MI 48083-2169
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009147
MI
Other
Enumeration date
06/03/2019
Last updated
06/03/2019
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