Provider Demographics
NPI:1760650691
Name:ROMANO, LINDA (BS,MPT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:ROMANO
Suffix:
Gender:F
Credentials:BS,MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33497 23 MILE RD
Mailing Address - Street 2:STE 170
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48047-4062
Mailing Address - Country:US
Mailing Address - Phone:586-716-1278
Mailing Address - Fax:586-716-1282
Practice Address - Street 1:33497 23 MILE RD
Practice Address - Street 2:STE 170
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48047-4062
Practice Address - Country:US
Practice Address - Phone:586-716-1278
Practice Address - Fax:586-716-1282
Is Sole Proprietor?:No
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist