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General NPI Number Information
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NPI Number | 1972137156
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Entity Type | Organization
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Legal Business Name | OPTIMA PHYSICAL THERAPY PLLC
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Dates
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Enumeration Date | 02/26/2020
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Last Update Date | 03/12/2020
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Provider Practice Location Address
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Address Line | 4250 N SAGINAW ST STE C
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City | FLINT
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State | MI
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Zip | 48505-5332
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Country | US
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Telephone | 810-406-9466
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Fax |
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Provider Business Mailing Address
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Address Line | 6206 EMERALD DR
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City | GRAND BLANC
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State | MI
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Zip | 48439-7809
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Country | US
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Telephone | 810-406-9466
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. STEPHEN RACHEL O'BRIEN
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Credential | PT, DPT
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Telephone | 810-406-9466
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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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