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General NPI Number Information
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NPI Number | 1861215501
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Entity Type | Organization
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Legal Business Name | THERAWELL PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 11/01/2024
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Last Update Date | 11/01/2024
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Provider Practice Location Address
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Address Line | 25136 W 6 MILE RD
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City | REDFORD
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State | MI
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Zip | 48240-2102
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Country | US
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Telephone | 313-648-2682
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Fax |
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Provider Business Mailing Address
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Address Line | 25136 W 6 MILE RD
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City | REDFORD
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State | MI
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Zip | 48240-2102
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Country | US
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Telephone | 313-648-2682
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ALIA MAKKI
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Credential | PT
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Telephone | 313-648-2682
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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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