Provider Demographics
NPI:1336649920
Name:ANCIER, ALIZA CHANA (PT, DPT)
Entity Type:Individual
Prefix:
First Name:ALIZA
Middle Name:CHANA
Last Name:ANCIER
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:ALIZA
Other - Middle Name:
Other - Last Name:KAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1787 W BIG BEAVER RD STE 250
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-3547
Mailing Address - Country:US
Mailing Address - Phone:248-712-4400
Mailing Address - Fax:
Practice Address - Street 1:1787 W BIG BEAVER RD STE 250
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48084-3547
Practice Address - Country:US
Practice Address - Phone:248-712-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-02-20
Last Update Date:2018-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010185092251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic