Individual
MRS. JANICE GAIL BRACKENBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
16200 19 MILE RD, CLINTON TOWNSHIP, MI 48038-1103
(586) 416-2065
(586) 228-7159
Mailing address
2818 SERRA DR, STERLING HEIGHTS, MI 48310-5257
(586) 977-0052
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06001592A
IN
Other
Enumeration date
05/21/2007
Last updated
07/08/2007
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