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General NPI Number Information
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NPI Number | 1841693876
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Entity Type | Organization
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Legal Business Name | NEURO-TECH RECOVERY SYSTEMS
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Dates
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Enumeration Date | 10/05/2014
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Last Update Date | 06/05/2024
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Provider Practice Location Address
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Address Line | 14575 BAINBRIDGE ST
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City | LIVONIA
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State | MI
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Zip | 48154-3601
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Country | US
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Telephone | 734-272-8698
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Fax |
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Provider Business Mailing Address
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Address Line | 14575 BAINBRIDGE ST
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City | LIVONIA
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State | MI
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Zip | 48154-3601
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Country | US
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Telephone | 734-272-8698
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Fax |
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Authorized Official
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Title or Position | FOUNDER
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Name | HENDRIKA LUBERTHA LIETZ
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Credential | PT, DPT, NCS
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Telephone | 734-272-8698
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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 | 5501003124
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License Number State | MI
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