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NPI Code Detail

MEDICARE: WAYNE COUNTY PHYSICAL THERAPY LLC

MEDICARE: WAYNE COUNTY PHYSICAL THERAPY LLC
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
1261QR0400XRehabilitation Clinic/Center

General Provider Information

NPI Number : 1487951075
Entity Type Code : Organization
Provider Name (Legal Business Name) : WAYNE COUNTY PHYSICAL THERAPY LLC
Provider Business Mailing Address
First Line : 1647 INKSTER RD
Second Line : SUITE C
City : GARDEN CITY
State : MI
Zip : 48135-3086
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1647 INKSTER RD
Second Line : SUITE C
City : GARDEN CITY
State : MI
Zip : 48135-3086
Country : US
Telephone Number : 734-266-1700
Fax Number :
Authorized Official
Title or Position : CEO
Name : MRS. NUSRAT JAURA
Credential :
Telephone Number : 734-266-1700
Provider Enumeration Date : 02/17/2011
Last Update Date : 02/17/2011

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Directions to “WAYNE COUNTY PHYSICAL THERAPY LLC ” Practice Location

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