Individual
ERICK POLANCO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
590 E GRAND BLVD, DETROIT, MI 48207-3534
(313) 921-1580
Mailing address
590 E GRAND BLVD, DETROIT, MI 48207-3534
(313) 921-1580
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
5201009097
MI
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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