Provider Demographics
NPI:1679530612
Name:HANDS ON CENTER FOR PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:HANDS ON CENTER FOR PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MR
Authorized Official - First Name:HEINRICH
Authorized Official - Middle Name:O
Authorized Official - Last Name:COMUTH
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:734-455-8370
Mailing Address - Street 1:650 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-1711
Mailing Address - Country:US
Mailing Address - Phone:734-455-8370
Mailing Address - Fax:734-455-2924
Practice Address - Street 1:650 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-1711
Practice Address - Country:US
Practice Address - Phone:734-455-8370
Practice Address - Fax:734-455-2924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-26
Last Update Date:2012-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI30612OtherBLUE CROSS PROVIDER
MI236600Medicare ID - Type UnspecifiedMEDICARE