Healthcare Provider Details

I. General information

NPI: 1205865961
Provider Name (Legal Business Name): OMPT SPECIALISTS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 07/22/2025
Certification Date: 07/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1080 KIRTS BLVD STE 500
TROY MI
48084-4882
US

IV. Provider business mailing address

1080 KIRTS BLVD SUITE 300
TROY MI
48084-4841
US

V. Phone/Fax

Practice location:
  • Phone: 248-353-1234
  • Fax: 248-353-1211
Mailing address:
  • Phone: 248-353-1234
  • Fax: 248-743-1237

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MR. MICHAEL N FAHMY
Title or Position: PRESIDENT/OWNER
Credential: DPT, OMPT
Phone: 248-353-1234