Provider Demographics
NPI:1538218367
Name:PICKERMAN, JOEL GREGORY (ATC)
Entity type:Individual
Prefix:
First Name:JOEL
Middle Name:GREGORY
Last Name:PICKERMAN
Suffix:
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 S STATE ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48109-2202
Mailing Address - Country:US
Mailing Address - Phone:734-763-6891
Mailing Address - Fax:
Practice Address - Street 1:1000 S STATE ST
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48109-2202
Practice Address - Country:US
Practice Address - Phone:734-763-6891
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist