Provider Demographics
NPI:1164693982
Name:THE PHYSICAL THERAPY CONNECTION, INC.
Entity Type:Organization
Organization Name:THE PHYSICAL THERAPY CONNECTION, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LANDGRAF
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:517-703-9262
Mailing Address - Street 1:1161 E CLARK RD
Mailing Address - Street 2:SUITE 156
Mailing Address - City:DEWITT
Mailing Address - State:MI
Mailing Address - Zip Code:48820-7930
Mailing Address - Country:US
Mailing Address - Phone:517-668-0000
Mailing Address - Fax:517-668-0017
Practice Address - Street 1:1161 E CLARK RD
Practice Address - Street 2:SUITE 156
Practice Address - City:DEWITT
Practice Address - State:MI
Practice Address - Zip Code:48820-7930
Practice Address - Country:US
Practice Address - Phone:517-668-0000
Practice Address - Fax:517-668-0017
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-03-19
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI929013261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy