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General NPI Number Information
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NPI Number | 1649860594
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Entity Type | Organization
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Legal Business Name | GO MOBILE PHYSICAL THERAPY & WELLNESS
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 01/27/2021
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Provider Practice Location Address
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Address Line | 347 PARK LN
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City | LINDEN
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State | MI
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Zip | 48451-9079
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Country | US
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Telephone | 810-215-9222
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Fax |
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Provider Business Mailing Address
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Address Line | 347 PARK LN
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City | LINDEN
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State | MI
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Zip | 48451-9079
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | SURROGATE
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Name | ANTHONY MARITATO
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Credential |
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Telephone | 513-420-9999
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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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