| NPI | 1114513033 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RYAN TISDALL Owner/Physical Therapist 248-957-9430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2020-12-15 |