Healthcare Provider Details

I. General information

NPI: 1427550482
Provider Name (Legal Business Name): HOOVER PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 06/27/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28671 HOOVER RD
WARREN MI
48093
US

IV. Provider business mailing address

33118 WENDY DR
STERLING HEIGHTS MI
48310-6471
US

V. Phone/Fax

Practice location:
  • Phone: 248-217-7327
  • Fax:
Mailing address:
  • Phone: 248-217-7327
  • Fax: 586-920-2678

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QR0400X
TaxonomyRehabilitation Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. RAMA T GERA
Title or Position: OWNER
Credential:
Phone: 248-217-7327