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General NPI Number Information
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NPI Number | 1083096176
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Entity Type | Organization
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Legal Business Name | PURE THERAPY CENTERS LLC
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 06/24/2015
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Provider Practice Location Address
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Address Line | 10423 W WARREN AVE STE 100
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City | DEARBORN
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State | MI
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Zip | 48126-1660
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Country | US
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Telephone | 313-438-6053
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Fax | 313-442-0790
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Provider Business Mailing Address
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Address Line | 10423 W WARREN AVE STE 100
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City | DEARBORN
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State | MI
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Zip | 48126-1660
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Country | US
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Telephone | 313-438-6053
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Fax | 313-442-0790
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Authorized Official
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Title or Position | OWNER
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Name | RANDY HOURANI
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Credential |
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Telephone | 313-438-6053
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State | MI
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