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General NPI Number Information
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NPI Number | 1952440497
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Entity Type | Organization
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Legal Business Name | SPARTAN PHYSICAL THERAPY ,INC.
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 28373 DEQUINDRE RD
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City | MADISON HTS
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State | MI
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Zip | 48071-3003
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Country | US
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Telephone | 248-542-7440
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Fax | 248-545-4327
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Provider Business Mailing Address
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Address Line | 56187 NICKELBY S
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City | SHELBY TOWNSHIP
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State | MI
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Zip | 48316-5502
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Country | US
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Telephone | 248-542-7440
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Fax | 248-545-4327
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. SULTAN MAHMOOD
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Credential | RPT
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Telephone | 248-542-7440
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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 | 5501004932
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License Number State | MI
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