Healthcare Provider Details

I. General information

NPI: 1164433223
Provider Name (Legal Business Name): EAST METRO PHYSICAL THERAPY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2006
Last Update Date: 01/17/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36341 HARPER AVE
CLINTON TOWNSHIP MI
48035
US

IV. Provider business mailing address

42615 GARFIELD
CLINTON TOWNSHIP MI
48038
US

V. Phone/Fax

Practice location:
  • Phone: 586-792-9190
  • Fax: 586-792-0547
Mailing address:
  • Phone: 586-412-2845
  • Fax: 586-286-0427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM H DWIGHT
Title or Position: OWNER ADMINISTRATOR
Credential: PT
Phone: 248-866-4364