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General NPI Number Information
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NPI Number | 1356599922
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Entity Type | Organization
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Legal Business Name | THERAMATRIX, INC.
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Dates
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Enumeration Date | 09/08/2008
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Last Update Date | 12/14/2016
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Provider Practice Location Address
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Address Line | 23411 GRATIOT
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City | EASTPOINTE
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State | MI
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Zip | 48021-1644
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Country | US
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Telephone | 586-776-0080
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Fax | 786-776-4349
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Provider Business Mailing Address
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Address Line | 900 AUBURN AVE
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City | PONTIAC
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State | MI
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Zip | 48342-3300
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Country | US
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Telephone | 248-333-3335
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Fax | 248-333-0276
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Authorized Official
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Title or Position | CEO
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Name | MR. RICHARD WHITTON
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Credential |
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Telephone | 248-333-3335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State | MI
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