Healthcare Provider Details

I. General information

NPI: 1750763207
Provider Name (Legal Business Name): OAK PARK CENTER FOR PHYSICAL THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/22/2015
Last Update Date: 06/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12702 W 9 MILE RD
OAK PARK MI
48237-2959
US

IV. Provider business mailing address

12702 W 9 MILE RD
OAK PARK MI
48237-2959
US

V. Phone/Fax

Practice location:
  • Phone: 248-798-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code273Y00000X
TaxonomyRehabilitation Hospital Unit
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code283X00000X
TaxonomyRehabilitation Hospital
License Number
License Number State

VIII. Authorized Official

Name: JAY ROSETT
Title or Position: MEMBER
Credential:
Phone: 248-798-5000