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1073152252 NPI number — RECOVERY PHYSICAL THERAPY, LLC

NPI Number: 1073152252
Health Care Provider/Practitioner: RECOVERY PHYSICAL THERAPY, LLC

Information about “1073152252” NPI (RECOVERY PHYSICAL THERAPY, LLC) exists in 1073152252 in HTML format HTML  |  1073152252 in plain Text format TXT  |  1073152252 in PDF (Portable Document Format) PDF  |  1073152252 in an XML format XML  formats.

NPI Number : 1073152252 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1073152252",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RECOVERY PHYSICAL THERAPY, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "29240 BUCKINGHAM ST STE 10",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "LIVONIA",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48154-4575",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "734-855-4572",
    "MailingAddressFaxNumber": "734-855-4573",
    "FirstLinePracticeLocationAddress": "29240 BUCKINGHAM ST STE 10",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LIVONIA",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48154-4575",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "734-855-4572",
    "PracticeLocationAddressFaxNumber": "734-855-4573",
    "EnumerationDate": "01/05/2020",
    "LastUpdateDate": "01/05/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "RAHMAN",
    "AuthorizedOfficialFirstName": "HEDAYAT",
    "AuthorizedOfficialMiddleName": "UR",
    "AuthorizedOfficialTitle": "MANAGER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PT",
    "AuthorizedOfficialTelephoneNumber": "248-346-5589",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "261QP2000X",
        "TaxonomyName": "Physical Therapy Clinic/Center",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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