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1346893682 NPI number — RESTORATIVE PHYSICAL THERAPY SERVICES, LLC

NPI Number: 1346893682
Health Care Provider/Practitioner: RESTORATIVE PHYSICAL THERAPY SERVICES, LLC

Information about “1346893682” NPI (RESTORATIVE PHYSICAL THERAPY SERVICES, LLC) exists in 1346893682 in HTML format HTML  |  1346893682 in plain Text format TXT  |  1346893682 in PDF (Portable Document Format) PDF  |  1346893682 in an XML format XML  formats.

NPI Number : 1346893682 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1346893682",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "RESTORATIVE PHYSICAL THERAPY SERVICES, LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "17200 E 10 MILE RD STE 165",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "EASTPOINTE",
    "MailingAddressStateName": "MI",
    "MailingAddressPostalCode": "48021-3349",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "586-298-6909",
    "MailingAddressFaxNumber": "586-298-6914",
    "FirstLinePracticeLocationAddress": "17200 E 10 MILE RD STE 165",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "EASTPOINTE",
    "PracticeLocationAddressStateName": "MI",
    "PracticeLocationAddressPostalCode": "48021-3349",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "586-298-6909",
    "PracticeLocationAddressFaxNumber": "586-298-6914",
    "EnumerationDate": "07/16/2019",
    "LastUpdateDate": "07/22/2019",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "KARAM",
    "AuthorizedOfficialFirstName": "JAWAD",
    "AuthorizedOfficialMiddleName": "ALAM",
    "AuthorizedOfficialTitle": "OWNER/DIRECTOR",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "DPT",
    "AuthorizedOfficialTelephoneNumber": "248-296-4053",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "225100000X",
        "TaxonomyName": "Physical Therapist",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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