Provider Demographics
NPI:1215682182
Name:MICAKOVIC, HANA (PT, DPT)
Entity type:Individual
Prefix:
First Name:HANA
Middle Name:
Last Name:MICAKOVIC
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60327 CREEKSIDE CT
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48094-2122
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1349 S ROCHESTER RD STE 215
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-3152
Practice Address - Country:US
Practice Address - Phone:248-239-5310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-18
Last Update Date:2024-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist