Healthcare Provider Details

I. General information

NPI: 1619960267
Provider Name (Legal Business Name): OCCUPATIONAL AND PHYSICAL THERAPY ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/30/2005
Last Update Date: 08/21/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39500 W 10 MILE RD SUITE 108
NOVI MI
48375-2947
US

IV. Provider business mailing address

39500 W 10 MILE RD SUITE 108
NOVI MI
48375-2947
US

V. Phone/Fax

Practice location:
  • Phone: 248-888-6800
  • Fax:
Mailing address:
  • Phone: 248-888-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: LAURA RUPPENTHAL
Title or Position: DIRECTOR
Credential: OTRL, CHT
Phone: 248-885-2307