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General NPI Number Information
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NPI Number | 1366899205
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Entity Type | Organization
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Legal Business Name | NEXT LEVEL HOME THERAPY SERVICES
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Dates
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Enumeration Date | 05/20/2016
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Last Update Date | 05/20/2016
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Provider Practice Location Address
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Address Line | 9760 MANDON RD
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City | WHITE LAKE
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State | MI
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Zip | 48386-2949
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Country | US
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Telephone | 248-388-1362
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Fax | 810-720-6389
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Provider Business Mailing Address
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Address Line | 9760 MANDON RD
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City | WHITE LAKE
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State | MI
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Zip | 48386-2949
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Country | US
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Telephone | 248-388-1362
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Fax | 810-720-6389
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Authorized Official
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Title or Position | OWNER
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Name | DANDRA L HEILMAN
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Credential |
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Telephone | 248-388-1362
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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 | 5501016732
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License Number State | MI
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