Provider Demographics
NPI:1720377047
Name:VASQUEZ, JOHN MICHAEL MAAPNI (RPT)
Entity Type:Individual
Prefix:
First Name:JOHN MICHAEL
Middle Name:MAAPNI
Last Name:VASQUEZ
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29391 JENNIFER DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-3922
Mailing Address - Country:US
Mailing Address - Phone:586-489-4511
Mailing Address - Fax:
Practice Address - Street 1:25958 W 6 MILE RD
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48240-2213
Practice Address - Country:US
Practice Address - Phone:313-286-3360
Practice Address - Fax:313-286-3363
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-07
Last Update Date:2017-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012225225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist