| Mrs Bryony Fawne Derose, OTR | |
|
22731 Newman Street Suite100b, Dearborn, MI 48124 | |
| (313) 791-0616 | |
| Not Available |
| Full Name | Mrs Bryony Fawne Derose |
|---|---|
| Gender | Female |
| Speciality | Occupational Therapist - Hand |
| Location | 22731 Newman Street Suite100b, Dearborn, Michigan |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689875841 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225XH1200X | Occupational Therapist - Hand | 5201005966 (Michigan) | Primary |
| Provider Name | Athletico Ltd |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1821085028 PECOS PAC ID: 4789602681 Enrollment ID: O20191218001701 |
| Mailing Address | Practice Location Address |
|---|---|
| Mrs Bryony Fawne Derose, OTR 22731 Newman Suite 100b, Dearborn, MI 48124 Ph: (313) 791-0616 | Mrs Bryony Fawne Derose, OTR 22731 Newman Street Suite100b, Dearborn, MI 48124 Ph: (313) 791-0616 |
Ms. Samantha Baker, OTRL Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 22731 Newmand Street, Suite 100b, Dearborn, MI 48124 Phone: 313-791-0616 | |
Calleigh-reese Coffin, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 1 Parklane Blvd Ste E200, Dearborn, MI 48126 Phone: 586-204-5560 | |
Adrienna Bartnicki, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3101 S Gulley Rd Ste F-g, Dearborn, MI 48124 Phone: 734-407-2500 | |
Ms. Melanie Ward, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 20469 Outer Dr, Dearborn, MI 48124 Phone: 734-282-2100 | |
Rachel E Basile, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 18101 Oakwood Blvd, Dearborn, MI 48124 Phone: 313-593-7760 | |
Taylor Pauline Talbot, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 3101 S Gulley Rd Ste F, Dearborn, MI 48124 Phone: 734-407-2500 Fax: 313-792-8962 | |
Nicole Renee Colleran, OTR/L Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 18501 Rotunda Dr Ste 100, Dearborn, MI 48124 Phone: 313-996-1951 |