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NPI Code Detail

MEDICARE: GENEX PHYSICAL THERAPY

MEDICARE: GENEX 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
1261QP2000XPhysical Therapy Clinic/Center5501009827MI

General Provider Information

NPI Number : 1720313588
Entity Type Code : Organization
Provider Name (Legal Business Name) : GENEX PHYSICAL THERAPY
Provider Business Mailing Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number : 313-228-5271
Fax Number : 313-228-5274
Provider Business Practice Location Address
First Line : 4953 SCHAEFER RD
Second Line :
City : DEARBORN
State : MI
Zip : 48126-3260
Country : US
Telephone Number : 313-228-5271
Fax Number : 313-228-5274
Authorized Official
Title or Position : DIRECTOR
Name : DR. KALLIL I. KAZAN
Credential :
Telephone Number : 313-228-5271
Provider Enumeration Date : 10/13/2009
Last Update Date : 10/13/2009

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Directions to “GENEX PHYSICAL THERAPY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.