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General NPI Number Information
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NPI Number | 1457022345
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Entity Type | Organization
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Legal Business Name | REFINE PHYSICAL THERAPY AND WELLNESS, LLC
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Dates
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Enumeration Date | 09/21/2021
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Last Update Date | 12/26/2023
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Provider Practice Location Address
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Address Line | 44670 ANN ARBOR RD W STE 140
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City | PLYMOUTH
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State | MI
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Zip | 48170-3962
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Country | US
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Telephone | 734-658-6522
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Fax | 734-545-8135
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Provider Business Mailing Address
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Address Line | 8489 KINGSLEY DR
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City | CANTON
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State | MI
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Zip | 48187-1915
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Country | US
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Telephone | 734-658-6522
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Fax | 734-545-8135
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Authorized Official
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Title or Position | PHYSICAL THERAPIST
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Name | DR. NICOLE TERESA LORENZ
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Credential | DPT
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Telephone | 734-658-6522
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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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Taxonomy #2
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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