Healthcare Provider Details

I. General information

NPI: 1215172408
Provider Name (Legal Business Name): SYNERGY PHYSICAL THERAPY GROUP TRI COUNTY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/03/2008
Last Update Date: 04/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26850 PROVIDENCE PKWY SUITE 260
NOVI MI
48374-1213
US

IV. Provider business mailing address

61 COMMERCE AVE SW
GRAND RAPIDS MI
49503-4124
US

V. Phone/Fax

Practice location:
  • Phone: 248-735-8272
  • Fax: 248-735-7276
Mailing address:
  • Phone: 616-940-0660
  • Fax: 616-940-1965

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. SAKARI PERTTULA
Title or Position: PHYSICAL THERAPIST
Credential: PT
Phone: 616-285-1377