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General NPI Number Information
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NPI Number | 1619172673
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Entity Type | Organization
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Legal Business Name | CKS OF MT CLEMENS LLC
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Dates
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Enumeration Date | 06/19/2007
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Last Update Date | 01/26/2023
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Provider Practice Location Address
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Address Line | 243 CASS AVE
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-2124
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Country | US
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Telephone | 586-783-7590
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Fax |
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Provider Business Mailing Address
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Address Line | 1773 STAR BATT DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48309-3708
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Country | US
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Telephone | 248-601-9207
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JULIE MARTEL
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Credential |
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Telephone | 248-601-9207
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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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