Healthcare Provider Details

I. General information

NPI: 1285357384
Provider Name (Legal Business Name): FREEDOM PHYSICAL THERAPY AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/22/2022
Last Update Date: 05/11/2023
Certification Date: 05/11/2023
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: 586-260-0515
  • Fax:
Mailing address:
  • Phone: 586-430-1154
  • Fax: 586-430-1174

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: CYRSTEN ZAPINSKI
Title or Position: OFFICE MANAGER
Credential:
Phone: 586-430-1154