MEDICARE: FITWELL PHYSICAL THERAPY INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	5501002474	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0H202460	OTHER	MI	BCBS OF MI
2	650H200720	OTHER	MI	BCBS OF MI
3	0H200720	OTHER	MI	BCBS OF MI

General Provider Information

NPI Number	:	1346371259
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FITWELL PHYSICAL THERAPY INC

Provider Business Mailing Address
First Line	:	26336 E HURON RIVER DR
Second Line	:
City	:	FLAT ROCK
State	:	MI
Zip	:	48134-1833
Country	:	US
Telephone Number	:	737-789-8281
Fax Number	:	734-789-8258

Provider Business Practice Location Address
First Line	:	26336 E HURON RIVER DR
Second Line	:
City	:	FLAT ROCK
State	:	MI
Zip	:	48134-1833
Country	:	US
Telephone Number	:	737-789-8281
Fax Number	:	734-789-8258

Authorized Official
Title or Position	:	OWNER
Name	:	MRS. ALLISON SCHMIT
Credential	:
Telephone Number	:	734-789-8281

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	07/03/2009

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Directions to “FITWELL PHYSICAL THERAPY INC ” Practice Location

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