Individual
JENNIFER MARIE DICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT, OMPT
Contact information
Practice address
67962 VAN DYKE RD, ROMEO, MI 48065-5163
(586) 336-4022
(586) 336-4082
Mailing address
878 S ROCHESTER RD, ROCHESTER HILLS, MI 48307-2767
(248) 601-9207
(248) 650-8670
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
5501011225
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650E008430
BCBSM
MI
Enumeration date
03/16/2007
Last updated
07/24/2012
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