| NPI | 1316757446 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELSEY ROLA Admin Assistant 248-922-2683 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports |
| Enumeration Date | 2025-01-10 |
| Last Update Date | 2025-01-10 |