Provider Demographics
NPI:1174366827
Name:MVPT PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:MVPT PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DALTON
Authorized Official - Middle Name:
Authorized Official - Last Name:GREYERBIEHL
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-874-4920
Mailing Address - Street 1:2500 NORMANDY RD UNIT 66
Mailing Address - Street 2:
Mailing Address - City:ROYAL OAK
Mailing Address - State:MI
Mailing Address - Zip Code:48073-1883
Mailing Address - Country:US
Mailing Address - Phone:248-874-4920
Mailing Address - Fax:
Practice Address - Street 1:2085 FRANKLIN RD STE B
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48302-0054
Practice Address - Country:US
Practice Address - Phone:248-874-4920
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty