| NPI | 1003946625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROGER WILLIAM GOBLE Co Owner 248-888-6800 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501006760) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2012-11-21 |