Provider Demographics
NPI:1750449237
Name:ZALESKI, NICHOLE MARIE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:NICHOLE
Middle Name:MARIE
Last Name:ZALESKI
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7357 S HURON RIVER DR
Mailing Address - Street 2:
Mailing Address - City:SOUTH ROCKWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:48179-9604
Mailing Address - Country:US
Mailing Address - Phone:734-379-0941
Mailing Address - Fax:
Practice Address - Street 1:3200 BIDDLE ST
Practice Address - Street 2:3 RD FLOOR
Practice Address - City:WYANDOTTE
Practice Address - State:MI
Practice Address - Zip Code:48192-5937
Practice Address - Country:US
Practice Address - Phone:734-324-3981
Practice Address - Fax:734-284-4696
Is Sole Proprietor?:No
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009505225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist