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General NPI Number Information
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NPI Number | 1861851255
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Entity Type | Organization
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Legal Business Name | HAMILTON PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 02/15/2016
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Last Update Date | 02/03/2023
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Provider Practice Location Address
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Address Line | 102 N ADELAIDE ST STE B
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City | FENTON
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State | MI
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Zip | 48430-2670
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Country | US
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Telephone | 810-354-8900
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Fax | 810-354-8902
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Provider Business Mailing Address
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Address Line | 102 N ADELAIDE ST STE B
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City | FENTON
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State | MI
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Zip | 48430-2670
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Country | US
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Telephone | 810-354-8900
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Fax | 810-354-8902
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Authorized Official
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Title or Position | PRESIDENT
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Name | JASON HAMILTON
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Credential | PT, MPT, OCS
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Telephone | 810-354-8900
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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 | 5501010353
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License Number State | MI
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