Provider Demographics
NPI:1508943853
Name:THIBODEAU PHYSICAL THERAPY LIMITED PARTNERSHIP
Entity Type:Organization
Organization Name:THIBODEAU PHYSICAL THERAPY LIMITED PARTNERSHIP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:
Authorized Official - Last Name:BINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-297-7000
Mailing Address - Street 1:1794 N LAPEER RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:LAPEER
Mailing Address - State:MI
Mailing Address - Zip Code:48446-7751
Mailing Address - Country:US
Mailing Address - Phone:810-664-3000
Mailing Address - Fax:810-664-9775
Practice Address - Street 1:1794 N LAPEER RD
Practice Address - Street 2:SUITE C
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-7751
Practice Address - Country:US
Practice Address - Phone:810-664-3000
Practice Address - Fax:810-664-9775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-01
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P50880Medicare PIN