Healthcare Provider Details

I. General information

NPI: 1306110093
Provider Name (Legal Business Name): PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2012
Last Update Date: 02/28/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5757 WHITMORE LAKE RD SUITE 900
BRIGHTON MI
48116-1962
US

IV. Provider business mailing address

9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US

V. Phone/Fax

Practice location:
  • Phone: 810-220-5793
  • Fax: 810-220-5805
Mailing address:
  • Phone: 734-416-3900
  • Fax: 734-416-3903

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BINSTEIN
Title or Position: VP, AUTHORIZED OFFICIAL
Credential: JD
Phone: 713-297-7000