Provider Demographics
NPI:1124306618
Name:KERASIOTIS, APOSTOLOS GEORGE (DPT)
Entity type:Individual
Prefix:DR
First Name:APOSTOLOS
Middle Name:GEORGE
Last Name:KERASIOTIS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30695 LITTLE MACK AVE
Mailing Address - Street 2:SUITE 600
Mailing Address - City:ROSEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48066-1771
Mailing Address - Country:US
Mailing Address - Phone:586-294-9030
Mailing Address - Fax:586-294-9033
Practice Address - Street 1:30695 LITTLE MACK AVE SUITE 600
Practice Address - Street 2:
Practice Address - City:ROSEVILLE
Practice Address - State:MI
Practice Address - Zip Code:48066-1771
Practice Address - Country:US
Practice Address - Phone:586-294-9030
Practice Address - Fax:586-294-9033
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-01
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501002451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist