Individual
MRS. JULIE RICKETT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
215 E MAIN ST, SUITE B, NORTHVILLE, MI 48167-1681
(248) 349-9339
Mailing address
215 E MAIN ST, SUITE B, NORTHVILLE, MI 48167-1681
(248) 349-9339
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501009202
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H20094
BCBS
MI
01
—
0N58620
HAP
MI
01
—
16869
M-CARE
MI
01
—
500573
CARE CHOICES
MI
01
—
7543420
AETNA
MI
01
—
P00100555
MEDICARE RAILROAD
MI
Enumeration date
01/31/2007
Last updated
07/08/2007
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