Healthcare Provider Details
I. General information
NPI: 1073842167
Provider Name (Legal Business Name): HEALING TOUCH PHYSICAL & OCCUPATIONAL THERAPY INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/18/2009
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
455 E GRAND RIVER AVE SUITE 104A
BRIGHTON MI
48116-1551
US
IV. Provider business mailing address
455 E GRAND RIVER AVE SUITE 104A
BRIGHTON MI
48116-1551
US
V. Phone/Fax
- Phone: 810-360-5890
- Fax:
- Phone: 810-360-5890
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | 5501006022 |
| License Number State | MI |
VIII. Authorized Official
Name: MR.
SAMIR
KUMAR
BARMAN
Title or Position: PHYSICAL THERAPIST
Credential: DPT
Phone: 810-360-5890