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General NPI Number Information
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NPI Number | 1083012322
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Entity Type | Organization
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Legal Business Name | GOLDEN PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 12/19/2014
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Provider Practice Location Address
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Address Line | 22243 WEST WARREN ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127
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Country | US
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Telephone | 313-406-9446
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Fax | 313-551-4768
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Provider Business Mailing Address
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Address Line | 22243 WEST WARREN ST
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127
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Country | US
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Telephone | 313-406-9446
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Fax | 313-551-4768
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | ALI S MAKKI
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Credential | M.D.
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Telephone | 313-695-3191
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | MI
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