Provider Demographics
NPI:1265656581
Name:HOORN, MICHAEL SCOTT (PT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:SCOTT
Last Name:HOORN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3010 W SCHAFER RD
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-8948
Mailing Address - Country:US
Mailing Address - Phone:734-878-5992
Mailing Address - Fax:
Practice Address - Street 1:2305 GENOA BUSINESS PARK DR.
Practice Address - Street 2:SUITE 170
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48114
Practice Address - Country:US
Practice Address - Phone:810-299-8550
Practice Address - Fax:810-844-0837
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010070732251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic