Provider Demographics
NPI:1568653814
Name:HUTCHINSON, DAVID GEORGE (PT)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GEORGE
Last Name:HUTCHINSON
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 1:2430 EMERSON AVE
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0433
Mailing Address - Country:US
Mailing Address - Phone:248-334-5495
Mailing Address - Fax:
Practice Address - Street 1:29703 HOOVER RD STE A
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48093-8901
Practice Address - Country:US
Practice Address - Phone:586-582-0340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI1995973225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist