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General NPI Number Information
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NPI Number | 1902847833
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Entity Type | Organization
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Legal Business Name | DEARBORN PHYSICAL THERAPY LTD.
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Dates
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Enumeration Date | 06/10/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 15245 DIX TOLEDO RD
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City | SOUTHGATE
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State | MI
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Zip | 48195-3445
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Country | US
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Telephone | 734-284-6582
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Fax | 734-284-7085
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Provider Business Mailing Address
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Address Line | 1300 W SAM HOUSTON PKWY S SUITE 300
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City | HOUSTON
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State | TX
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Zip | 77042-2447
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Country | US
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Telephone | 713-297-7000
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Fax | 713-297-7090
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Authorized Official
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Title or Position | VP/AUTHORIZED OFFICIAL
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Name | JANNA P. KING
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Credential | JD
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Telephone | 713-297-7000
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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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