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General NPI Number Information
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NPI Number | 1386946291
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Entity Type | Organization
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Legal Business Name | QUANTUM PHYSICAL THERAPY-BELLEVILLE LLC
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Dates
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Enumeration Date | 11/29/2010
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Last Update Date | 11/30/2010
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Provider Practice Location Address
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Address Line | 11650 BELLEVILLE RD
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City | BELLEVILLE
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State | MI
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Zip | 48111-3380
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Country | US
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Telephone | 734-325-2443
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Fax | 734-325-2447
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Provider Business Mailing Address
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Address Line | 11650 BELLEVILLE RD
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City | BELLEVILLE
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State | MI
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Zip | 48111-3380
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Country | US
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Telephone | 734-325-2443
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Fax | 734-325-2447
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Authorized Official
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Title or Position | OWNER
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Name | MR. TIZIANO MAROVINO
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Credential | DPT
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Telephone | 734-483-9200
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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 |
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License Number State |
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