Provider Demographics
NPI:1346850823
Name:MILESTONES PEDIATRIC PHYSICAL THERAPY
Entity Type:Organization
Organization Name:MILESTONES PEDIATRIC PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:
Authorized Official - Last Name:MALUSHI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-622-1854
Mailing Address - Street 1:18161 W 13 MILE RD STE B4
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-1113
Mailing Address - Country:US
Mailing Address - Phone:248-792-7019
Mailing Address - Fax:248-297-6838
Practice Address - Street 1:18161 W 13 MILE RD STE B4
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-1113
Practice Address - Country:US
Practice Address - Phone:248-792-7019
Practice Address - Fax:248-297-6838
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-09
Last Update Date:2024-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty