Individual
MR. NICHOLAS ANGELO POLYDORAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
29510 7 MILE RD, LIVONIA, MI 48152-1910
(248) 427-9525
(248) 427-9528
Mailing address
29510 7 MILE RD, LIVONIA, MI 48152-1910
(248) 427-9525
(248) 427-9528
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201005125
MI
Other
Enumeration date
09/28/2007
Last updated
09/28/2007
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