| NPI | 1487899811 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKOLAJ LODZINSKI Administrator 313-891-0505 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501004579) |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2008-12-15 |