Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Evan Fitzgerald, PTA

Individual provider Physical Therapy Assistant · NPI 1417315250

Evan Fitzgerald, PTA is a Physical Therapy Assistant in Walled Lake, Michigan. Licensed in Michigan. Registered with an NPI since 2016.

Licensed in
MI
In the registry since
2016
What do these letters mean?
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

1505 Oakshade St #61
Walled Lake, MI 48390-2173 Not confirmed with CMS for 10 years — call before visiting
Phone: (248) 635-5256
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence 5502004814 (MI)

Record details

NPI number1417315250
Entity typeIndividual (Type 1)
GenderMale
Credentials PTA
Sole proprietorNo
NPI enumeratedFebruary 8, 2016
Last updated in NPPESFebruary 8, 2016