Healthcare Provider Details

I. General information

NPI: 1700594140
Provider Name (Legal Business Name): SNM PHYSICAL THERAPY L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/14/2022
Last Update Date: 08/09/2023
Certification Date: 08/09/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37860 VAN DYKE AVE
STERLING HEIGHTS MI
48312-1840
US

IV. Provider business mailing address

PO BOX 725010
BERKLEY MI
48072-5010
US

V. Phone/Fax

Practice location:
  • Phone: 248-630-6373
  • Fax:
Mailing address:
  • Phone: 844-766-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: NEELAM THAWANI
Title or Position: MANAGER
Credential: PT
Phone: 248-630-6373