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Individual

AMANDA ILLA PICKWORTH-CHRUSCIEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PT, DPT

Contact information

Practice address
17783 HAGGERTY RD STE B, NORTHVILLE CHARTER TOWNSHIP, MI 48168-9802
(734) 895-1901
(855) 794-1008
Mailing address
5536 RESEARCH DR STE A, CANTON, MI 48188-2261
(734) 895-1901
(855) 794-1008

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501303770
MI
225200000X
Physical Therapy Assistant
5502003904
MI

Other

Enumeration date
06/04/2019
Last updated
02/05/2025
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