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General NPI Number Information
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NPI Number | 1295123586
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Entity Type | Organization
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Legal Business Name | SAGINAW HORIZON PHYSICAL THERAPY AND REHABILITATION, PLLC
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Dates
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Enumeration Date | 01/08/2015
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Last Update Date | 11/29/2016
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Provider Practice Location Address
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Address Line | 4705 TOWNE CENTRE RD SUITE 101
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City | SAGINAW
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State | MI
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Zip | 48604-2818
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Country | US
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Telephone | 989-401-5890
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Fax | 989-401-5892
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Provider Business Mailing Address
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Address Line | 4705 TOWNE CENTRE RD SUITE 101
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City | SAGINAW
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State | MI
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Zip | 48604-2818
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Country | US
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Telephone | 989-401-5890
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Fax | 989-401-5892
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Authorized Official
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Title or Position | PRESIDENT/ADMINISTRATOR
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Name | KRISHNA CHALASANI
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Credential | PT
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Telephone | 989-401-5890
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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 | E2848Q
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License Number State | MI
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Taxonomy #2
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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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