Individual
SERGEI M ANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
198 S MAIN ST STE 1, MOUNT CLEMENS, MI 48043-7917
(586) 477-1402
Mailing address
2327 LAKESHORE BLVD APT 631, YPSILANTI, MI 48198-6915
(734) 717-2239
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005359
MI
Other
Enumeration date
11/28/2018
Last updated
11/28/2018
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