Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
EVAN FITZGERALD, PTA
ActiveEVAN FITZGERALD, PTA is a Occupational Therapist healthcare provider located in WALLED LAKE, Michigan. NPI 1417315250 is currently active in the NPPES registry. Verify at CMS.
Occupational Therapist · WALLED LAKE, MI
Registration Details
- NPI Number
- 1417315250
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Feb 8, 2016 (10.492099438005 yrs)
- Last Updated
- Feb 8, 2016
- License
-
5502004814 (MI)
Practice Information
- Address
-
1505 OAKSHADE ST#61WALLED LAKE, MI, 483902173Browse MI providers · Browse ZIP 48390
- Phone
- 2486355256
- Primary Specialty
-
Occupational Therapist
225200000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.