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NPI Code Detail

MEDICARE: UZNIS PHYSICAL THERAPY

MEDICARE: UZNIS PHYSICAL THERAPY
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
1174400000XSpecialist5501008061MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130392OTHERMIBLUE CROSS
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1518184969
Entity Type Code : Organization
Provider Name (Legal Business Name) : UZNIS PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 22909 SOCIA ST
Second Line :
City : SAINT CLAIR SHORES
State : MI
Zip : 48082-3029
Country : US
Telephone Number : 586-850-5947
Fax Number :
Provider Business Practice Location Address
First Line : 18101 E WARREN AVE
Second Line :
City : DETROIT
State : MI
Zip : 48224-1382
Country : US
Telephone Number : 313-881-5678
Fax Number : 313-881-9337
Authorized Official
Title or Position : PHYSICAL THERAPIST
Name : JACQUELINE R VANEECKE
Credential : PT
Telephone Number : 313-881-5678
Provider Enumeration Date : 04/19/2007
Last Update Date : 08/22/2020

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Directions to “UZNIS PHYSICAL THERAPY ” Practice Location

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