MEDICARE: PHYSIOTHERAPY ASSOCIATES 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	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1497947618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHYSIOTHERAPY ASSOCIATES INC

Provider Business Mailing Address
First Line	:	15151 STANTON ST
Second Line	:	STE B
City	:	WEST OLIVE
State	:	MI
Zip	:	49460-8543
Country	:	US
Telephone Number	:	616-844-1290
Fax Number	:	616-844-1652

Provider Business Practice Location Address
First Line	:	15151 STANTON ST
Second Line	:	STE B
City	:	WEST OLIVE
State	:	MI
Zip	:	49460-8543
Country	:	US
Telephone Number	:	616-844-1290
Fax Number	:	616-844-1652

Authorized Official
Title or Position	:	CONTRACTING
Name	:	ROB ZIGENFUS
Credential	:
Telephone Number	:	901-685-7227

Provider Enumeration Date	:	08/11/2007
Last Update Date	:	08/11/2007

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Directions to “PHYSIOTHERAPY ASSOCIATES INC ” Practice Location

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