Provider Demographics
NPI:1780839118
Name:CASALOU, JUDITH ANN (PA)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:ANN
Last Name:CASALOU
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Gender:F
Credentials:PA
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Mailing Address - Street 1:5301 E HURON RIVER DR
Mailing Address - Street 2:SUITE C-139
Mailing Address - City:YPSILANTI
Mailing Address - State:MI
Mailing Address - Zip Code:48197-1051
Mailing Address - Country:US
Mailing Address - Phone:734-721-1000
Mailing Address - Fax:734-721-1012
Practice Address - Street 1:5301 E HURON RIVER DR
Practice Address - Street 2:SUITE C-139
Practice Address - City:YPSILANTI
Practice Address - State:MI
Practice Address - Zip Code:48197-1051
Practice Address - Country:US
Practice Address - Phone:734-721-1000
Practice Address - Fax:734-721-1012
Is Sole Proprietor?:No
Enumeration Date:2008-11-26
Last Update Date:2011-08-18
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Provider Licenses
StateLicense IDTaxonomies
MI5601003511363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical