Provider Demographics
NPI:1942845581
Name:WARRICK, ALICIA ANN GILLMAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:ANN GILLMAN
Last Name:WARRICK
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2109 THORNRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:GRAND BLANC
Mailing Address - State:MI
Mailing Address - Zip Code:48439-8993
Mailing Address - Country:US
Mailing Address - Phone:989-630-7535
Mailing Address - Fax:
Practice Address - Street 1:10483 DIXIE HWY
Practice Address - Street 2:
Practice Address - City:HOLLY
Practice Address - State:MI
Practice Address - Zip Code:48442-9311
Practice Address - Country:US
Practice Address - Phone:810-771-7686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-07
Last Update Date:2019-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501019399225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist