| NPI | 1548374473 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PIERRE A LUYCKX Owner 269-556-0881 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: MI 5501008773) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: MI 5501007604) |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2011-02-04 |