Provider Demographics
NPI:1336683408
Name:AKRAM, ATHENA (DPT)
Entity Type:Individual
Prefix:
First Name:ATHENA
Middle Name:
Last Name:AKRAM
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29701 TRANCREST ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-4534
Mailing Address - Country:US
Mailing Address - Phone:248-277-1613
Mailing Address - Fax:
Practice Address - Street 1:29701 TRANCREST ST
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-4534
Practice Address - Country:US
Practice Address - Phone:248-277-1613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-08
Last Update Date:2021-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015950225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist