Healthcare Provider Details

I. General information

NPI: 1265738058
Provider Name (Legal Business Name): HEALTHSTYLES SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/27/2011
Last Update Date: 08/09/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 S LAFAYETTE ST
SOUTH LYON MI
48178-1407
US

IV. Provider business mailing address

42615 GARFIELD RD
CLINTON TOWNSHIP MI
48038-1653
US

V. Phone/Fax

Practice location:
  • Phone: 248-486-1110
  • Fax:
Mailing address:
  • Phone: 586-412-2845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. GWYNLYN SWARTZ
Title or Position: CORPORATE ADMINISTRATOR
Credential:
Phone: 586-412-2846