Provider Demographics
NPI:1003860099
Name:HINTERMAN, CAROLEE MAE (PT)
Entity Type:Individual
Prefix:MRS
First Name:CAROLEE
Middle Name:MAE
Last Name:HINTERMAN
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MISS
Other - First Name:CAROLEE
Other - Middle Name:MAE
Other - Last Name:WENZLICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:2574 N ASHWOOD PASS
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48642-7878
Mailing Address - Country:US
Mailing Address - Phone:989-430-9457
Mailing Address - Fax:989-835-9518
Practice Address - Street 1:2574 N ASHWOOD PASS
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48642-7878
Practice Address - Country:US
Practice Address - Phone:989-430-9457
Practice Address - Fax:989-835-9518
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501003000208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation