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NPI Code Detail

MEDICARE: THERAMATRIX, INC.

MEDICARE: THERAMATRIX, 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
1225100000XPhysical Therapist

General Provider Information

NPI Number : 1760489678
Entity Type Code : Organization
Provider Name (Legal Business Name) : THERAMATRIX, INC.
Provider Business Mailing Address
First Line : 900 AUBURN AVE
Second Line :
City : PONTIAC
State : MI
Zip : 48342-3300
Country : US
Telephone Number : 248-333-3335
Fax Number : 248-333-0276
Provider Business Practice Location Address
First Line : 900 AUBURN
Second Line :
City : PONTIAC
State : MI
Zip : 48342-3300
Country : US
Telephone Number : 248-333-3335
Fax Number : 248-333-0276
Authorized Official
Title or Position : CEO
Name : MR. RICHARD WHITTON
Credential :
Telephone Number : 248-333-3335
Provider Enumeration Date : 07/07/2005
Last Update Date : 12/09/2016

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