Healthcare Provider Details

I. General information

NPI: 1366069114
Provider Name (Legal Business Name): ELIZABETH ANNE CARY PT, DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH ANNE KINGSHOTT CARY PT, DPT

II. Dates (important events)

Enumeration Date: 06/28/2020
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5688 N TELEGRAPH RD
DEARBORN HEIGHTS MI
48127-3219
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 313-633-9586
  • Fax: 313-633-9589
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11162R
License Number StateLA
# 2
Primary TaxonomyN
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number11859
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501303122
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: