| NPI | 1669932505 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA JEAN MARKS CEO 313-587-2679 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Additional Taxonomies | 225100000X Physical Therapist |
| 261Q00000X Clinic/Center | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2019-03-25 |
| Last Update Date | 2019-03-25 |