Individual
CYNTHIA BANTOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
25700 LAHSER RD, SOUTHFIELD, MI 48033-5809
(248) 415-2500
(248) 415-2511
Mailing address
25700 LAHSER RD, SOUTHFIELD, MI 48033-5809
(248) 415-2500
(248) 415-2511
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5201002206
MI
Other
Enumeration date
08/01/2016
Last updated
08/01/2016
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