Provider Demographics
NPI:1275170888
Name:PHYSICAL THERAPY SOLUTIONS SERVICE
Entity Type:Organization
Organization Name:PHYSICAL THERAPY SOLUTIONS SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FULLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-233-2044
Mailing Address - Street 1:24423 SOUTHFIELD RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-2864
Mailing Address - Country:US
Mailing Address - Phone:248-233-6199
Mailing Address - Fax:248-233-6199
Practice Address - Street 1:24423 SOUTHFIELD RD STE 100
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-2864
Practice Address - Country:US
Practice Address - Phone:248-233-6199
Practice Address - Fax:248-233-6199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-02
Last Update Date:2023-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty