Provider Demographics
NPI:1649400250
Name:HOWARD, MARYANN (DPT)
Entity Type:Individual
Prefix:MRS
First Name:MARYANN
Middle Name:
Last Name:HOWARD
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 1:5400 S PENNSYLVANIA AVE
Mailing Address - Street 2:
Mailing Address - City:LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48911-4049
Mailing Address - Country:US
Mailing Address - Phone:517-393-7325
Mailing Address - Fax:517-393-2320
Practice Address - Street 1:5400 S PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48911-4049
Practice Address - Country:US
Practice Address - Phone:517-393-7325
Practice Address - Fax:517-393-2320
Is Sole Proprietor?:No
Enumeration Date:2009-07-16
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501014580225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist