Healthcare Provider Details

I. General information

NPI: 1467581728
Provider Name (Legal Business Name): KEITH L. KRINGS PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 09/29/2020
Certification Date: 09/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2625 PLYMOUTH RD
ANN ARBOR MI
48105-2468
US

IV. Provider business mailing address

740 W GRAND RIVER AVE
BRIGHTON MI
48116-2392
US

V. Phone/Fax

Practice location:
  • Phone: 734-585-3313
  • Fax: 734-585-3315
Mailing address:
  • Phone: 810-227-3588
  • Fax: 810-626-4045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501003624
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: