MEDICARE: PHYSICAL THERAPY CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center	5501005281	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1487631966
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSICAL THERAPY CENTER

Provider Business Mailing Address
First Line	:	586 S ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2736
Country	:	US
Telephone Number	:	248-651-4573
Fax Number	:	248-651-5394

Provider Business Practice Location Address
First Line	:	586 S ROCHESTER RD
Second Line	:
City	:	ROCHESTER HILLS
State	:	MI
Zip	:	48307-2736
Country	:	US
Telephone Number	:	248-651-4573
Fax Number	:	248-651-5394

Authorized Official
Title or Position	:	ADMINISTRATOR
Name	:	MR. RAKESH SACHDEVA
Credential	:	RPT
Telephone Number	:	248-651-4573

Provider Enumeration Date	:	12/27/2005
Last Update Date	:	02/27/2009

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Directions to “PHYSICAL THERAPY CENTER ” Practice Location

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