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General NPI Number Information
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NPI Number | 1275240483
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Entity Type | Organization
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Legal Business Name | PLACE OF HEALING PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 10/28/2022
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Last Update Date | 10/28/2022
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Provider Practice Location Address
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Address Line | 43191 DALCOMA DR STE 105
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City | CLINTON TOWNSHIP
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State | MI
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Zip | 48038-6308
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Country | US
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Telephone | 248-495-0605
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Fax |
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Provider Business Mailing Address
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Address Line | 4807 BRUNER DR
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City | STERLING HEIGHTS
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State | MI
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Zip | 48310-2604
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Country | US
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Telephone | 248-495-0605
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MRS. MARY JANE OGOY-FERRER
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Credential | PT
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Telephone | 248-495-0605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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