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General NPI Number Information
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NPI Number | 1477555142
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Entity Type | Organization
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Legal Business Name | P.T. SERVICES REHABILITATION, INC.
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Dates
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Enumeration Date | 08/12/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15555 S TELEGRAPH RD SUITE 13
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City | MONROE
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State | MI
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Zip | 48161-4000
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Country | US
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Telephone | 419-447-7203
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Fax | 419-447-5577
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Provider Business Mailing Address
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Address Line | PO BOX 833
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City | TIFFIN
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State | OH
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Zip | 44883-0833
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Country | US
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Telephone | 419-447-7203
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Fax | 419-447-5577
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. TINA M. DEITEMEYER
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Credential | CCA
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Telephone | 419-447-7203
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 | MI
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