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General NPI Number Information
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NPI Number | 1245286384
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Entity Type | Organization
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Legal Business Name | VISITING THERAPIST INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 11/03/2011
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Provider Practice Location Address
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Address Line | 28459 DEQUINDRE RD STE D
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3080
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Country | US
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Telephone | 248-298-0221
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Fax | 248-298-0224
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Provider Business Mailing Address
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Address Line | 28459 DEQUINDRE RD STE D
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City | MADISON HEIGHTS
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State | MI
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Zip | 48071-3080
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Country | US
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Telephone | 248-298-0221
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Fax | 248-298-0224
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Authorized Official
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Title or Position | CEO
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Name | ALI AL-KHAFAJI
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Credential |
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Telephone | 248-298-0221
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 540F311980
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License Number State | MI
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