| NPI | 1306182514 |
|---|---|
| Doing Business As | ACTIVERX OF WEST BLOOMFIELD |
| Entity Type | Organization |
| Authorized Contact | MARK DAVID LINES Owner 248-932-0111 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Enumeration Date | 2012-12-14 |
| Last Update Date | 2012-12-24 |