Provider Demographics
NPI:1487833844
Name:FUNCTIONAL PHYSICAL THERAPY OF ROYAL OAK
Entity Type:Organization
Organization Name:FUNCTIONAL PHYSICAL THERAPY OF ROYAL OAK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AKANT
Authorized Official - Middle Name:R
Authorized Official - Last Name:DOSHI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-673-2762
Mailing Address - Street 1:4206 PONTIAC LAKE RD
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48328-1261
Mailing Address - Country:US
Mailing Address - Phone:248-673-2762
Mailing Address - Fax:248-673-3347
Practice Address - Street 1:3216 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:ROYAL OAK
Practice Address - State:MI
Practice Address - Zip Code:48073-3507
Practice Address - Country:US
Practice Address - Phone:248-673-2762
Practice Address - Fax:248-673-3347
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-01
Last Update Date:2007-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty