Provider Demographics
NPI:1073152252
Name:RECOVERY PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:RECOVERY PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:HEDAYAT
Authorized Official - Middle Name:UR
Authorized Official - Last Name:RAHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-346-5589
Mailing Address - Street 1:29240 BUCKINGHAM ST STE 10
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-4575
Mailing Address - Country:US
Mailing Address - Phone:734-855-4572
Mailing Address - Fax:734-855-4573
Practice Address - Street 1:29240 BUCKINGHAM ST STE 10
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4575
Practice Address - Country:US
Practice Address - Phone:734-855-4572
Practice Address - Fax:734-855-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-05
Last Update Date:2020-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy