| NPI | 1629461363 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA HERZOG Consultant 248-306-9068 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| Enumeration Date | 2015-03-05 |
| Last Update Date | 2015-03-05 |