Provider Demographics
NPI:1174620397
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR PAYOR CONTRACTING
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:ZIGENFUS
Authorized Official - Suffix:JR
Authorized Official - Credentials:
Authorized Official - Phone:901-685-7227
Mailing Address - Street 1:2055 CROOKS RD
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48309-3245
Mailing Address - Country:US
Mailing Address - Phone:248-844-8002
Mailing Address - Fax:248-844-8007
Practice Address - Street 1:2055 CROOKS RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48309-3245
Practice Address - Country:US
Practice Address - Phone:248-844-8002
Practice Address - Fax:248-844-8007
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI236573Medicare Oscar/Certification