Provider Demographics
NPI:1376094268
Name:THERAHEALTH PHYSIO THERAPY
Entity Type:Organization
Organization Name:THERAHEALTH PHYSIO THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZEINAB
Authorized Official - Middle Name:
Authorized Official - Last Name:ABDALLAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-443-8088
Mailing Address - Street 1:20755 GREENFIELD RD
Mailing Address - Street 2:SUITE 602
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-5403
Mailing Address - Country:US
Mailing Address - Phone:248-443-8088
Mailing Address - Fax:248-443-8099
Practice Address - Street 1:20755 GREENFIELD RD
Practice Address - Street 2:SUITE 602
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-5403
Practice Address - Country:US
Practice Address - Phone:248-443-8088
Practice Address - Fax:248-443-8099
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-17
Last Update Date:2016-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes305R00000XManaged Care OrganizationsPreferred Provider Organization