Provider Demographics
NPI:1548317688
Name:VANHULLE, ERIC JOSEPH (PT MPT OMPT CSCS)
Entity type:Individual
Prefix:MR
First Name:ERIC
Middle Name:JOSEPH
Last Name:VANHULLE
Suffix:
Gender:M
Credentials:PT MPT OMPT CSCS
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:33900 HARPER AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:CLINTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4258
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13850 E 12 MILE RD # 2A
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:MI
Practice Address - Zip Code:48088-3730
Practice Address - Country:US
Practice Address - Phone:586-445-3945
Practice Address - Fax:586-350-2011
Is Sole Proprietor?:No
Enumeration Date:2007-01-04
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI55010108472251X0800X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic