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General NPI Number Information
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NPI Number | 1275747941
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Entity Type | Organization
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Legal Business Name | PHYSICAL THERAPY TEAM, P.C.
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Dates
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Enumeration Date | 05/10/2007
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Last Update Date | 11/06/2013
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Provider Practice Location Address
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Address Line | 24060 W 10 MILE RD STE 102
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City | SOUTHFIELD
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State | MI
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Zip | 48033-3006
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Country | US
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Telephone | 248-746-1132
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Fax | 248-746-1133
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Provider Business Mailing Address
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Address Line | 28871 FARMINGTON RD
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-2613
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Country | US
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Telephone | 313-618-1041
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | NATHANIEL DAVIS
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Credential |
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Telephone | 313-618-1041
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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