Healthcare Provider Details

I. General information

NPI: 1376135483
Provider Name (Legal Business Name): JORDAN PHILLIP ZAPINSKI PT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2021
Last Update Date: 07/13/2023
Certification Date: 07/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67232 GRATIOT AVE
RICHMOND MI
48062-1915
US

IV. Provider business mailing address

67232 GRATIOT AVE
RICHMOND MI
48062-1915
US

V. Phone/Fax

Practice location:
  • Phone: 586-430-1154
  • Fax:
Mailing address:
  • Phone: 586-430-1154
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number2201019964
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: