Healthcare Provider Details
I. General information
NPI: 1962097634
Provider Name (Legal Business Name): PT SOLUTIONS OF MICHIGAN LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 03/04/2021
Last Update Date: 03/04/2021
Certification Date: 03/04/2021
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2300 GENOA BUSINESS PARK DR STE 270
BRIGHTON MI
48114-7369
US
IV. Provider business mailing address
1100 CIRCLE 75 PKWY SE STE 1400
ATLANTA GA
30339-3067
US
V. Phone/Fax
- Phone: 810-772-4964
- Fax: 810-772-4973
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225X00000X |
| Taxonomy | Occupational Therapist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
CARMEN
PHILPOT
Title or Position: DIRECTOR OF REVENUE CYCLE
Credential:
Phone: 678-403-3568