Provider Demographics
NPI:1053699728
Name:PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP
Entity type:Organization
Organization Name:PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:LAWRANCE
Authorized Official - Middle Name:W
Authorized Official - Last Name:MCAFEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:9368 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4610
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:870 E ARKONA RD
Practice Address - Street 2:SUITE 110
Practice Address - City:MILAN
Practice Address - State:MI
Practice Address - Zip Code:48160-9770
Practice Address - Country:US
Practice Address - Phone:734-439-2200
Practice Address - Fax:734-439-2204
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PLYMOUTH PHYSICAL THERAPY SPECIALISTS LIMITED PARTNERSHIP
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-29
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P39200Medicare PIN