Healthcare Provider Details

I. General information

NPI: 1013521210
Provider Name (Legal Business Name): AJ LEWANDOWSKI DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/04/2020
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50174 SCHOENHERR RD
SHELBY TWP MI
48315-3136
US

IV. Provider business mailing address

33900 HARPER AVE STE 104
CLINTON TWP MI
48035-4258
US

V. Phone/Fax

Practice location:
  • Phone: 586-884-5040
  • Fax: 586-580-0375
Mailing address:
  • Phone: 586-350-2644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501019584
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: