Individual
GERALD POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
42955 FORD RD, CANTON, MI 48187-3377
(734) 981-2100
(734) 981-2622
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501013845
MI
Other
Enumeration date
06/30/2008
Last updated
06/16/2014
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