Individual
MR. ATILANO MANUELITO MENDOZA MANALESE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPT
Contact information
Practice address
18763 FARMINGTON RD, LIVONIA, MI 48152-3262
(248) 426-0572
Mailing address
18763 FARMINGTON RD, LIVONIA, MI 48152-3262
(248) 426-0572
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011779
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5501011779
PHYSICAL THERAPIST LICENSE
MI
Enumeration date
06/07/2012
Last updated
04/05/2024
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