Healthcare Provider Details

I. General information

NPI: 1265103162
Provider Name (Legal Business Name): PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2021
Last Update Date: 03/01/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4844 N ADAMS RD
OAKLAND TOWNSHIP MI
48306-1415
US

IV. Provider business mailing address

9368 N LILLEY RD
PLYMOUTH MI
48170-4610
US

V. Phone/Fax

Practice location:
  • Phone: 248-726-7015
  • Fax: 734-416-3904
Mailing address:
  • Phone: 734-416-3900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

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