Individual
CARRIE BASHISTA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
42400 W 12 MILE RD, NOVI, MI 48377-3015
(734) 386-0804
Mailing address
37503 LADYWOOD ST, LIVONIA, MI 48154-1446
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502000422
MI
Other
Enumeration date
07/27/2022
Last updated
07/27/2022
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