Provider Demographics
NPI:1316584451
Name:MANUAL PHYSICAL THERAPY SPECIALISTS, LLC
Entity Type:Organization
Organization Name:MANUAL PHYSICAL THERAPY SPECIALISTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:KARIKALAN
Authorized Official - Middle Name:
Authorized Official - Last Name:VELUSAMY
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:810-730-2299
Mailing Address - Street 1:2740 E LANSING DR STE B
Mailing Address - Street 2:
Mailing Address - City:EAST LANSING
Mailing Address - State:MI
Mailing Address - Zip Code:48823-2898
Mailing Address - Country:US
Mailing Address - Phone:810-730-2299
Mailing Address - Fax:
Practice Address - Street 1:2740 E LANSING DR STE B
Practice Address - Street 2:
Practice Address - City:EAST LANSING
Practice Address - State:MI
Practice Address - Zip Code:48823-2898
Practice Address - Country:US
Practice Address - Phone:810-730-2299
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-09
Last Update Date:2020-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty