Provider Demographics
NPI:1518253236
Name:KINETIC PHYSICAL THERAPY, P.C.
Entity Type:Organization
Organization Name:KINETIC PHYSICAL THERAPY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DHANARANI
Authorized Official - Middle Name:
Authorized Official - Last Name:NAVAROSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-634-0864
Mailing Address - Street 1:7686 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WESTLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48185-7695
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7686 CHERRYWOOD DR
Practice Address - Street 2:
Practice Address - City:WESTLAND
Practice Address - State:MI
Practice Address - Zip Code:48185-7695
Practice Address - Country:US
Practice Address - Phone:734-634-0864
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-21
Last Update Date:2011-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty