Basic Information
| Provider Information | |||||||||
| NPI: | 1336329747 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALL-PRO PHYSICAL THERAPY LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 37699 6 MILE RD | ||||||||
| Address2: | 200 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481523994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349534155 | ||||||||
| FaxNumber: | 7349531622 | ||||||||
| Practice Location | |||||||||
| Address1: | 37699 6 MILE RD | ||||||||
| Address2: | SUITE 200 | ||||||||
| City: | LIVONIA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481523994 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349534155 | ||||||||
| FaxNumber: | 7349531622 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/14/2007 | ||||||||
| LastUpdateDate: | 10/23/2013 | ||||||||
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| AuthorizedOfficialLastName: | AMIN | ||||||||
| AuthorizedOfficialFirstName: | RAJIV | ||||||||
| AuthorizedOfficialMiddleName: | PRAMOD | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 7349534155 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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| AuthorizedOfficialCredential: | MPT | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QP2000X | N | Ambulatory Health Care Facilities | Clinic/Center | Physical Therapy | 225100000X | 5501010339 | MI | Y | 193400000X SINGLE SPECIALTY GROUP | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.