Provider Demographics
NPI:1831673524
Name:APPLE, SAMUEL (DPT)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:
Last Name:APPLE
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6156 RICHARDS
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MI
Mailing Address - Zip Code:48116-9548
Mailing Address - Country:US
Mailing Address - Phone:810-599-6314
Mailing Address - Fax:
Practice Address - Street 1:455 E GRAND RIVER AVE STE 102
Practice Address - Street 2:
Practice Address - City:BRIGHTON
Practice Address - State:MI
Practice Address - Zip Code:48116-1563
Practice Address - Country:US
Practice Address - Phone:810-534-7004
Practice Address - Fax:810-775-1046
Is Sole Proprietor?:No
Enumeration Date:2018-09-19
Last Update Date:2018-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501018914225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist