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General NPI Number Information
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NPI Number | 1871065714
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Entity Type | Organization
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Legal Business Name | MAK PHYSICAL THERAPY
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Dates
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Enumeration Date | 12/17/2018
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Last Update Date | 07/23/2019
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Provider Practice Location Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334
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Country | US
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Telephone | 248-436-4400
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Fax |
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Provider Business Mailing Address
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Address Line | 27777 INKSTER RD STE 100
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City | FARMINGTON HILLS
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State | MI
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Zip | 48334-5326
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Country | US
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Telephone | 248-436-4400
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAMEL ALSAEDI
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Credential |
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Telephone | 313-641-5111
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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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