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General NPI Number Information
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NPI Number | 1861050098
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Entity Type | Organization
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Legal Business Name | PHYSIO4RELIEF PC
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Dates
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Enumeration Date | 06/03/2019
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 4764 DIXIE HWY STE 150
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City | WATERFORD
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State | MI
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Zip | 48329-3525
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Country | US
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Telephone | 248-686-9613
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Fax |
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Provider Business Mailing Address
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Address Line | 2655 CHEROKEE HILLS CIR
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City | WATERFORD
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State | MI
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Zip | 48328-3190
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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 | CONTRACTING SPECIALIST
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Name | SHAVETA ARYA
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Credential |
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Telephone | 248-247-1586
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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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