Provider Demographics
NPI:1598011652
Name:THE GLOBAL PT LLC
Entity Type:Organization
Organization Name:THE GLOBAL PT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MARK
Authorized Official - Middle Name:
Authorized Official - Last Name:WOLODKOWICZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-255-6392
Mailing Address - Street 1:22150 GREENFIELD RD STE 101
Mailing Address - Street 2:
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-2535
Mailing Address - Country:US
Mailing Address - Phone:248-291-5801
Mailing Address - Fax:
Practice Address - Street 1:22150 GREENFIELD RD STE 101
Practice Address - Street 2:
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-2535
Practice Address - Country:US
Practice Address - Phone:248-291-5801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-26
Last Update Date:2012-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty