Basic Information
| Provider Information | |||||||||
| NPI: | 1881879823 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | SALINE PHYSICAL THERAPY OF MICHIGAN LTD. | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | PHYSICAL THERAPY IN MOTION | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1300 W SAM HOUSTON PKWY S | ||||||||
| Address2: | SUITE 300 | ||||||||
| City: | HOUSTON | ||||||||
| State: | TX | ||||||||
| PostalCode: | 770422447 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7132977000 | ||||||||
| FaxNumber: | 7132977090 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 E MICHIGAN AVE | ||||||||
| Address2: | |||||||||
| City: | SALINE | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481761588 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349441005 | ||||||||
| FaxNumber: | 7349441303 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/09/2008 | ||||||||
| LastUpdateDate: | 01/09/2008 | ||||||||
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| AuthorizedOfficialLastName: | KING | ||||||||
| AuthorizedOfficialFirstName: | JANNA | ||||||||
| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | VP, AUTHORIZED OFFICIAL | ||||||||
| AuthorizedOfficialTelephone: | 7132977000 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | JD | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332B00000X | Y | Suppliers | Durable Medical Equipment & Medical Supplies |
No ID Information.