Provider Demographics
NPI:1508636283
Name:CLEAR PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:CLEAR PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIMITRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCARY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-327-7548
Mailing Address - Street 1:17515 W 9 MILE RD STE 700
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48075-4403
Mailing Address - Country:US
Mailing Address - Phone:248-327-7548
Mailing Address - Fax:248-970-8477
Practice Address - Street 1:17515 W 9 MILE RD STE 700
Practice Address - Street 2:
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48075-4403
Practice Address - Country:US
Practice Address - Phone:248-327-7548
Practice Address - Fax:248-970-8477
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-04
Last Update Date:2024-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy