Provider Demographics
NPI:1841422730
Name:FRANCISCO, VIVIENE G (PT)
Entity type:Individual
Prefix:
First Name:VIVIENE
Middle Name:G
Last Name:FRANCISCO
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:175 E NAWAKWA RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48307-5269
Mailing Address - Country:US
Mailing Address - Phone:248-299-2628
Mailing Address - Fax:248-844-1220
Practice Address - Street 1:707 LAKE COOK RD STE 120
Practice Address - Street 2:
Practice Address - City:DEERFIELD
Practice Address - State:IL
Practice Address - Zip Code:60015-4909
Practice Address - Country:US
Practice Address - Phone:847-579-8810
Practice Address - Fax:857-580-1215
Is Sole Proprietor?:No
Enumeration Date:2009-08-11
Last Update Date:2024-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501013331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist