Healthcare Provider Details

I. General information

NPI: 1962673285
Provider Name (Legal Business Name): UZNIS-DWIGHT PHYSICAL THERAPY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/14/2008
Last Update Date: 08/14/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18101 E WARREN AVE
DETROIT MI
48224-1382
US

IV. Provider business mailing address

42615 GARFIELD RD
CLINTON TOWNSHIP MI
48038-1653
US

V. Phone/Fax

Practice location:
  • Phone: 313-881-5678
  • Fax: 313-881-9337
Mailing address:
  • Phone: 586-412-2845
  • Fax: 586-416-1497

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: MR. WILLIAM HOWARD DWIGHT
Title or Position: PRESIDENT
Credential: PT
Phone: 248-866-4364