Healthcare Provider Details

I. General information

NPI: 1952877300
Provider Name (Legal Business Name): NAVNEET VERMA PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/23/2018
Last Update Date: 10/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 POWELL DR
DUNDEE MI
48131-8644
US

IV. Provider business mailing address

23512 CHICORY RD
GROSSE ILE MI
48138-2192
US

V. Phone/Fax

Practice location:
  • Phone: 517-266-1481
  • Fax:
Mailing address:
  • Phone: 734-775-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501008588
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: