Provider Demographics
NPI:1619699295
Name:SIGNIFICA PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:SIGNIFICA PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MOIZ
Authorized Official - Middle Name:ALI
Authorized Official - Last Name:BOHRA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-516-3960
Mailing Address - Street 1:24100 DRAKE RD STE C
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48335-3155
Mailing Address - Country:US
Mailing Address - Phone:248-516-3960
Mailing Address - Fax:248-826-1646
Practice Address - Street 1:24100 DRAKE RD STE C
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-3155
Practice Address - Country:US
Practice Address - Phone:248-516-3960
Practice Address - Fax:248-826-1646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-12
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty