Healthcare Provider Details

I. General information

NPI: 1063381903
Provider Name (Legal Business Name): ZOMA PHYSICAL THERAPY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/30/2025
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5839 W MAPLE RD STE 125
WEST BLOOMFIELD MI
48322-2278
US

IV. Provider business mailing address

6817 LONG AVE
WEST BLOOMFIELD MI
48322-1249
US

V. Phone/Fax

Practice location:
  • Phone: 248-464-4044
  • Fax:
Mailing address:
  • Phone: 248-464-4044
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: TIMOTHY ZOMA
Title or Position: CEO
Credential: DPT
Phone: 248-464-4044