| NPI | 1790453322 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOUGLAS EDWARD JOHNSON Physical Therapist 586-615-8585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |