Provider Demographics
NPI:1750960860
Name:POWERS, NORA GRACE (PTA)
Entity type:Individual
Prefix:
First Name:NORA
Middle Name:GRACE
Last Name:POWERS
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13080 HILL RD
Mailing Address - Street 2:
Mailing Address - City:RILEY
Mailing Address - State:MI
Mailing Address - Zip Code:48041-1616
Mailing Address - Country:US
Mailing Address - Phone:810-300-3953
Mailing Address - Fax:
Practice Address - Street 1:67267 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:MI
Practice Address - Zip Code:48062-1919
Practice Address - Country:US
Practice Address - Phone:586-727-4530
Practice Address - Fax:586-727-9485
Is Sole Proprietor?:No
Enumeration Date:2021-04-06
Last Update Date:2021-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant