MEDICARE: SYNERGY PHYSICAL THERAPY AND WELLNESS LLC

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

General Provider Information

NPI Number	:	1669181731
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY PHYSICAL THERAPY AND WELLNESS LLC

Provider Business Mailing Address
First Line	:	2066 S WAYNE RD
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48186-5428
Country	:	US
Telephone Number	:	734-945-2143
Fax Number	:

Provider Business Practice Location Address
First Line	:	2066 S WAYNE RD
Second Line	:
City	:	WESTLAND
State	:	MI
Zip	:	48186-5428
Country	:	US
Telephone Number	:	734-945-2143
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	NAUSHEEN HAROON
Credential	:	DPT
Telephone Number	:	734-945-2143

Provider Enumeration Date	:	11/17/2022
Last Update Date	:	11/17/2022

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