Provider Demographics
NPI:1720125123
Name:ALLEN, JAMES PATRICK (PT, OMPT)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:PATRICK
Last Name:ALLEN
Suffix:
Gender:M
Credentials:PT, OMPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:44460 HIGHGATE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1489
Mailing Address - Country:US
Mailing Address - Phone:586-286-3746
Mailing Address - Fax:586-286-3325
Practice Address - Street 1:20952 E 12 MILE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48081-3200
Practice Address - Country:US
Practice Address - Phone:586-498-3500
Practice Address - Fax:586-498-3510
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIL9626442251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic