Individual
MR. DAX MARQUEZ CRISOSTOMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-7732
Mailing address
2333 BIDDLE AVE, WYANDOTTE, MI 48192-4668
(734) 246-7732
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012122
MI
Other
Enumeration date
05/04/2018
Last updated
05/04/2018
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