Basic Information
| Provider Information | |||||||||
| NPI: | 1184084840 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9368 N LILLEY RD | ||||||||
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| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481704610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344163900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 29525 FORD RD | ||||||||
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| City: | GARDEN CITY | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481352319 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7345220065 | ||||||||
| FaxNumber: | 7345220068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/24/2016 | ||||||||
| LastUpdateDate: | 02/24/2016 | ||||||||
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| AuthorizedOfficialLastName: | BINSTEIN | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | VP/AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 7132977000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.