Healthcare Provider Details
I. General information
NPI: 1275391369
Provider Name (Legal Business Name): PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/12/2024
Last Update Date: 03/12/2024
Certification Date: 03/12/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
17388 W 13 MILE RD
BEVERLY HILLS MI
48025-5438
US
IV. Provider business mailing address
9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US
V. Phone/Fax
- Phone: 248-731-0060
- Fax: 248-731-7062
- Phone: 734-416-3900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
RICHARD
BINSTEIN
Title or Position: EVP
Credential:
Phone: 713-297-7000