Basic Information
| Provider Information | |||||||||
| NPI: | 1487793394 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | OAKLAND PHYSICAL THERAPY, PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 26850 PROVIDENCE PKWY | ||||||||
| Address2: | SUITE 365 | ||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483741213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483803550 | ||||||||
| FaxNumber: | 2483801620 | ||||||||
| Practice Location | |||||||||
| Address1: | 26850 PROVIDENCE PKWY | ||||||||
| Address2: | SUITE 365 | ||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483741213 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2483803550 | ||||||||
| FaxNumber: | 2483801620 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/06/2007 | ||||||||
| LastUpdateDate: | 03/26/2009 | ||||||||
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| AuthorizedOfficialLastName: | KAVA | ||||||||
| AuthorizedOfficialFirstName: | FRANK | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2483803550 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | PT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | Y | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy |
No ID Information.