Provider Demographics
NPI:1790139020
Name:EHRMANN, PIMCHANOK
Entity Type:Individual
Prefix:MRS
First Name:PIMCHANOK
Middle Name:
Last Name:EHRMANN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 W CLARKSTON RD
Mailing Address - Street 2:SUITE15
Mailing Address - City:LAKE ORION
Mailing Address - State:MI
Mailing Address - Zip Code:48362-2892
Mailing Address - Country:US
Mailing Address - Phone:248-214-7386
Mailing Address - Fax:
Practice Address - Street 1:189 W CLARKSTON RD
Practice Address - Street 2:SUITE15
Practice Address - City:LAKE ORION
Practice Address - State:MI
Practice Address - Zip Code:48362-2892
Practice Address - Country:US
Practice Address - Phone:248-214-7386
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-04-23
Last Update Date:2016-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL979002172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist