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General NPI Number Information
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NPI Number | 1962924647
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Entity Type | Organization
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Legal Business Name | PHYSIOSTRONG LLC
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Dates
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Enumeration Date | 07/13/2017
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Last Update Date | 07/13/2017
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Provider Practice Location Address
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Address Line | 1025 WEBSTER ST
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City | BIRMINGHAM
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State | MI
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Zip | 48009-6932
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Country | US
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Telephone | 844-666-4546
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Fax |
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Provider Business Mailing Address
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Address Line | 8712 BUFFALO DR
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City | COMMERCE TOWNSHIP
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State | MI
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Zip | 48382-3410
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MR. COREY MCCUE
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Credential | PT, DPT, CSCS
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Telephone | 989-482-2375
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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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