Provider Demographics
NPI:1023554300
Name:GAMM, JAMIE (DPT)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:GAMM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:JAMIE
Other - Middle Name:
Other - Last Name:MONTEROSSO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:33900 HARPER AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:586-416-9100
Mailing Address - Fax:586-416-9103
Practice Address - Street 1:75 W SQUARE LAKE RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48098-2929
Practice Address - Country:US
Practice Address - Phone:248-688-9010
Practice Address - Fax:248-688-9013
Is Sole Proprietor?:No
Enumeration Date:2017-01-11
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018021225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist