Provider Demographics
NPI:1669632444
Name:ACUTE PHYSICAL THERAPY & PAIN MANAGEMENT, PC
Entity Type:Organization
Organization Name:ACUTE PHYSICAL THERAPY & PAIN MANAGEMENT, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR OF PHYSICAL THERAPY
Authorized Official - Prefix:DR
Authorized Official - First Name:WASEEM
Authorized Official - Middle Name:
Authorized Official - Last Name:AHMAD
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:734-837-9651
Mailing Address - Street 1:29240 BUCKINGHAM ST STE 8C
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48154-4575
Mailing Address - Country:US
Mailing Address - Phone:734-837-9651
Mailing Address - Fax:734-522-0686
Practice Address - Street 1:29240 BUCKINGHAM ST STE 8C
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-4575
Practice Address - Country:US
Practice Address - Phone:734-837-9651
Practice Address - Fax:734-522-0686
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-14
Last Update Date:2008-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501005637261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIPENDINGMedicare PIN