| NPI | 1528013588 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW JOSEPH FATE President 269-978-6990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2251G0304X Physical Therapist, Geriatrics (Licence: MI 5501009179) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 55501001115) |
| 225X00000X Occupational Therapist (Licence: MI 5201003557) | |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2020-08-22 |