Healthcare Provider Details

I. General information

NPI: 1336648161
Provider Name (Legal Business Name): ONWARD PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2018
Last Update Date: 02/28/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3250 W BIG BEAVER RD STE 300A
TROY MI
48084-2900
US

IV. Provider business mailing address

3250 W BIG BEAVER RD STE 300A
TROY MI
48084-2900
US

V. Phone/Fax

Practice location:
  • Phone: 248-792-3633
  • Fax: 248-281-0515
Mailing address:
  • Phone: 248-792-3633
  • Fax: 248-281-0515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. GREGORY H KIRK JR.
Title or Position: OWNER
Credential:
Phone: 248-792-3633