Individual
MR. ROLLIN DESEAN FOWLKES JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTRL
Contact information
Practice address
34330 VAN BORN RD, WAYNE, MI 48184-2472
(313) 287-0057
Mailing address
34330 VAN BORN RD, WAYNE, MI 48184-2472
(313) 287-0057
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
122821
TX
225X00000X
Occupational Therapist
Primary
5201008622
MI
Other
Enumeration date
09/29/2015
Last updated
04/28/2026
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