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General NPI Number Information
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NPI Number | 1598520686
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Entity Type | Organization
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Legal Business Name | MICHIGAN PHYSICAL THERAPY SERVICES LLC
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Dates
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Enumeration Date | 02/16/2024
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Last Update Date | 02/16/2024
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Provider Practice Location Address
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Address Line | 26211 CENTRAL PARK BLVD STE 116
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City | SOUTHFIELD
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State | MI
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Zip | 48076-4107
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Country | US
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Telephone | 248-482-3181
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Fax |
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Provider Business Mailing Address
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Address Line | 26211 CENTRAL PARK BLVD STE 116
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City | SOUTHFIELD
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State | MI
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Zip | 48076-4107
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Country | US
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Telephone | 248-482-3181
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | IRAM Q TARIQ
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Credential | OFFICE MANAGER
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Telephone | 248-482-3181
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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 |
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