Individual
MR. CLINT A TAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9301 CHARTER OAKS DR, DAVISON, MI 48423-3390
(989) 400-6999
Mailing address
9301 CHARTER OAKS DR, DAVISON, MI 48423-3390
(989) 400-6999
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009959
MI
2251G0304X
Geriatric Physical Therapist
5501009959
MI
2251X0800X
Orthopedic Physical Therapist
5501009959
MI
Other
Enumeration date
07/25/2007
Last updated
08/14/2007
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