Provider Demographics
NPI:1508311606
Name:BACK 2 HEALTH PHYSICAL THERAPY, LLC
Entity Type:Organization
Organization Name:BACK 2 HEALTH PHYSICAL THERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SUKHWANT
Authorized Official - Middle Name:SINGH
Authorized Official - Last Name:GILL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-439-0015
Mailing Address - Street 1:2311 15 MILE RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48310-4842
Mailing Address - Country:US
Mailing Address - Phone:586-439-0015
Mailing Address - Fax:586-883-9080
Practice Address - Street 1:2311 15 MILE RD
Practice Address - Street 2:SUITE C
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48310-4842
Practice Address - Country:US
Practice Address - Phone:586-439-0015
Practice Address - Fax:586-883-9080
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-18
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty