Individual
JESSE BINGHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
N14010 DEPAS LN, WILSON, MI 49896
(906) 399-6748
Mailing address
N14010 DEPAS LANE, WILSON, MI 49896
(906) 399-6748
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
09238
OR
225200000X
Physical Therapy Assistant
Primary
2117208
TX
Other
Enumeration date
04/14/2016
Last updated
04/14/2016
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