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Individual

MRS. ESRAA M MOUSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
6558 GREENFIELD RD, DEARBORN, MI 48126-1701
(313) 581-1155
Mailing address
PO BOX 804, DEARBORN, MI 48121-0804
(313) 715-7152
(313) 581-1144

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
832720547
AUTO
MI
Enumeration date
12/17/2018
Last updated
12/17/2018
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