Provider Demographics
NPI:1093130239
Name:ROBERTS, MICHAEL (DPT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2330 S MILFORD RD SUITE 108
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48357
Mailing Address - Country:US
Mailing Address - Phone:248-387-5494
Mailing Address - Fax:248-387-5495
Practice Address - Street 1:2330 S MILFORD RD SUITE 108
Practice Address - Street 2:
Practice Address - City:HIGHLAND
Practice Address - State:MI
Practice Address - Zip Code:48357
Practice Address - Country:US
Practice Address - Phone:248-387-5494
Practice Address - Fax:248-387-5495
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-25
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist