Basic Information
| Provider Information | |||||||||
| NPI: | 1265103162 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9368 N LILLEY RD | ||||||||
| Address2: | |||||||||
| City: | PLYMOUTH | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481704610 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7344163900 | ||||||||
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| Practice Location | |||||||||
| Address1: | 4844 N ADAMS RD | ||||||||
| Address2: | |||||||||
| City: | OAKLAND TOWNSHIP | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483061415 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487267015 | ||||||||
| FaxNumber: | 7344163904 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/22/2021 | ||||||||
| LastUpdateDate: | 03/01/2022 | ||||||||
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| AuthorizedOfficialLastName: | BINSTEIN | ||||||||
| AuthorizedOfficialFirstName: | RICHARD | ||||||||
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| AuthorizedOfficialTitleorPosition: | EVP | ||||||||
| AuthorizedOfficialTelephone: | 7132977000 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 03/01/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 225100000X | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.