Healthcare Provider Details

I. General information

NPI: 1427459015
Provider Name (Legal Business Name): ROBERT WILLIAM PRECHT III DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2014
Last Update Date: 09/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29525 FORD RD
GARDEN CITY MI
48135-2319
US

IV. Provider business mailing address

29525 FORD RD
GARDEN CITY MI
48135-2319
US

V. Phone/Fax

Practice location:
  • Phone: 734-522-0065
  • Fax: 734-522-0068
Mailing address:
  • Phone: 734-522-0065
  • Fax: 734-522-0068

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: