Individual
LUIS VILLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6057 WOODPECKER CT, YPSILANTI, MI 48197-6221
(734) 624-4601
Mailing address
6057 WOODPECKER CT, YPSILANTI, MI 48197-6221
(734) 624-4601
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5502005663
MI
Other
Enumeration date
01/28/2020
Last updated
01/28/2020
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