| NPI | 1487288916 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAUSHIK PATEL Credentialing 586-822-0007 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225200000X Physical Therapy Assistant |
| 225XP0019X Occupational Therapist, Physical Rehabilitation | |
| Enumeration Date | 2020-02-24 |
| Last Update Date | 2020-03-03 |