Healthcare Provider Details

I. General information

NPI: 1467235093
Provider Name (Legal Business Name): PROTERA HEALTH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/16/2023
Last Update Date: 02/08/2024
Certification Date: 02/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 W BIG BEAVER RD STE 300
TROY MI
48084-4725
US

IV. Provider business mailing address

43313 WOODWARD AVE # 1169
BLOOMFIELD HILLS MI
48302-5007
US

V. Phone/Fax

Practice location:
  • Phone: 810-331-0939
  • Fax: 855-850-4055
Mailing address:
  • Phone: 772-359-9429
  • 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: ERIC MAKHNI
Title or Position: CEO
Credential: MD
Phone: 772-359-9429