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General NPI Number Information
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NPI Number | 1134816648
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Entity Type | Organization
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Legal Business Name | JFIT, LLC
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Dates
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Enumeration Date | 04/24/2023
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Last Update Date | 04/24/2023
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Provider Practice Location Address
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Address Line | 1025 WEBSTER ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6932
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Country | US
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Telephone | 313-580-7525
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Fax |
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Provider Business Mailing Address
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Address Line | 29378 LAKE PARK DRIVE
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City | FARMINGTON HILLS
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State | MI
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Zip | 48331-2637
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Country | US
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Telephone | 313-580-7525
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | JUSTIN RADA
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Credential | DPT
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Telephone | 313-580-7525
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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 |
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