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General NPI Number Information
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NPI Number | 1578637161
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Entity Type | Organization
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Legal Business Name | ED FAHEY ASSOCIATES PC
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Dates
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Enumeration Date | 11/17/2006
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 6825 DIXIE HIGHWAY ROOM E
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City | CLARKSTON
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State | MI
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Zip | 48346
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Country | US
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Telephone | 248-625-6820
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Fax | 248-625-6821
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Provider Business Mailing Address
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Address Line | 6825 DIXIE HIGHWAY ROOM E
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City | CLARKSTON
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State | MI
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Zip | 48346
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Country | US
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Telephone | 248-625-6820
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Fax | 248-625-6821
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Authorized Official
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Title or Position | PRESIDENT OWNER
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Name | MR. EDWIN MATTHEW FAHEY JR.
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Credential | PT
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Telephone | 248-625-6820
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number |
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License Number State |
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