Individual
JESSICA PANECCASIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8711 BINNEY DR, WARREN, MI 48093-1602
(586) 246-8864
Mailing address
8711 BINNEY DR, WARREN, MI 48093-1602
(586) 246-8864
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501018555
MI
Other
Enumeration date
05/24/2018
Last updated
05/24/2018
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