MEDICARE: FIRST CHIOCE PHYSICAL THERAPY 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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1841512555
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	FIRST CHIOCE PHYSICAL THERAPY LLC

Provider Business Mailing Address
First Line	:	22150 GREENFIELD RD
Second Line	:	SUITE 101
City	:	OAK PARK
State	:	MI
Zip	:	48237-2535
Country	:	US
Telephone Number	:	248-967-2273
Fax Number	:	248-967-2266

Provider Business Practice Location Address
First Line	:	22150 GREENFIELD RD
Second Line	:	SUITE 101
City	:	OAK PARK
State	:	MI
Zip	:	48237-2535
Country	:	US
Telephone Number	:	248-967-2273
Fax Number	:	248-967-2266

Authorized Official
Title or Position	:	OWNER
Name	:	MR. FATIMA HASSAN
Credential	:
Telephone Number	:	248-967-2273

Provider Enumeration Date	:	02/22/2010
Last Update Date	:	02/22/2010

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