MEDICARE: TIMOTHY JOSEPH ZOMA DPT

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	225100000X	Physical Therapist	5501018098	MI

General Provider Information

NPI Number	:	1568903516
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY JOSEPH ZOMA DPT

Provider Business Mailing Address
First Line	:	5829 W MAPLE RD STE 125
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-2294
Country	:	US
Telephone Number	:	248-562-7097
Fax Number	:

Provider Business Practice Location Address
First Line	:	5829 W MAPLE RD STE 125
Second Line	:
City	:	WEST BLOOMFIELD
State	:	MI
Zip	:	48322-2294
Country	:	US
Telephone Number	:	248-562-7097
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/10/2017
Last Update Date	:	01/08/2026

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