Provider Demographics
NPI:1407392376
Name:PINILI, ROMMEL (PT)
Entity Type:Individual
Prefix:
First Name:ROMMEL
Middle Name:
Last Name:PINILI
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:549 LOCKMOORE CT
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-4228
Mailing Address - Country:US
Mailing Address - Phone:248-688-9106
Mailing Address - Fax:
Practice Address - Street 1:549 LOCKMOORE CT
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4228
Practice Address - Country:US
Practice Address - Phone:248-688-9106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-16
Last Update Date:2017-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009368225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist