Provider Demographics
NPI:1275240483
Name:PLACE OF HEALING PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:PLACE OF HEALING PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:OGOY-FERRER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-495-0605
Mailing Address - Street 1:4807 BRUNER DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-2604
Mailing Address - Country:US
Mailing Address - Phone:248-495-0605
Mailing Address - Fax:
Practice Address - Street 1:43191 DALCOMA DR STE 105
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48038-6308
Practice Address - Country:US
Practice Address - Phone:248-495-0605
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-28
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty