Provider Demographics
NPI:1356317994
Name:CIMINO, JOSEPH FRANCIS (AT,C)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:FRANCIS
Last Name:CIMINO
Suffix:
Gender:M
Credentials:AT,C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10983 LESURE DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1244
Mailing Address - Country:US
Mailing Address - Phone:586-979-8204
Mailing Address - Fax:
Practice Address - Street 1:15420 19 MILE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6339
Practice Address - Country:US
Practice Address - Phone:586-228-4830
Practice Address - Fax:586-228-4840
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer