Provider Demographics
NPI:1740908755
Name:NEWMAN, JERICA CLAIRE (PT, DPT)
Entity type:Individual
Prefix:
First Name:JERICA
Middle Name:CLAIRE
Last Name:NEWMAN
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:JERICA
Other - Middle Name:CLAIRE
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:734-416-3900
Mailing Address - Fax:734-453-2118
Practice Address - Street 1:37250 5 MILE RD # UNITED-1
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-1848
Practice Address - Country:US
Practice Address - Phone:734-462-3240
Practice Address - Fax:734-462-3831
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501302118225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist