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Individual

GERALD LEE PHILO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
5500 AUTO CLUB DR STE 150, DEARBORN, MI 48126-2779
(313) 982-8266
(313) 982-8098
Mailing address
5500 AUTO CLUB DR STE 150, DEARBORN, MI 48126-2779
(313) 982-8266
(313) 982-8098

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502000079
MI

Other

Enumeration date
03/17/2021
Last updated
03/24/2021
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