Provider Demographics
NPI:1902116478
Name:RAMOS, NICOLE DANIELLE (DPT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:DANIELLE
Last Name:RAMOS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8896 COMMERCE RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4494
Mailing Address - Country:US
Mailing Address - Phone:248-363-2115
Mailing Address - Fax:248-363-2308
Practice Address - Street 1:8896 COMMERCE RD
Practice Address - Street 2:SUITE 1
Practice Address - City:COMMERCE TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48382-4494
Practice Address - Country:US
Practice Address - Phone:248-363-2115
Practice Address - Fax:248-363-2308
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501015384225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist