Provider Demographics
NPI:1760710024
Name:FLINT PHYSICAL THERAPY SPECIALISTS
Entity Type:Organization
Organization Name:FLINT PHYSICAL THERAPY SPECIALISTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MARK
Authorized Official - Last Name:RUEDIGER
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:810-618-1897
Mailing Address - Street 1:432 N SAGINAW ST
Mailing Address - Street 2:SUITE 407
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48502-2013
Mailing Address - Country:US
Mailing Address - Phone:810-618-1897
Mailing Address - Fax:
Practice Address - Street 1:432 N SAGINAW ST
Practice Address - Street 2:SUITE 407
Practice Address - City:FLINT
Practice Address - State:MI
Practice Address - Zip Code:48502-2013
Practice Address - Country:US
Practice Address - Phone:810-618-1897
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-25
Last Update Date:2009-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501012113261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy