Healthcare Provider Details

I. General information

NPI: 1093892259
Provider Name (Legal Business Name): THIBODEAU PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 08/24/2023
Certification Date: 08/24/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1808 S CEDAR ST
IMLAY CITY MI
48444-9779
US

IV. Provider business mailing address

1300 W SAM HOUSTON PKWY S SUITE 300
HOUSTON TX
77042-2447
US

V. Phone/Fax

Practice location:
  • Phone: 810-721-0421
  • Fax: 810-721-0423
Mailing address:
  • Phone: 713-297-7000
  • Fax: 713-297-7090

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: RICHARD BINSTEIN
Title or Position: EVP
Credential:
Phone: 713-297-7000