Provider Demographics
NPI:1770006199
Name:PRIMARY PREVENTION PHYSIOTHERAPY PLLC
Entity Type:Organization
Organization Name:PRIMARY PREVENTION PHYSIOTHERAPY PLLC
Other - Org Name:PRIMARY PREVENTION PHYSIOTHERAPY PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AMBER
Authorized Official - Middle Name:M
Authorized Official - Last Name:SCHLEMMER
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:810-487-9733
Mailing Address - Street 1:209 S CHERRY ST
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:MI
Mailing Address - Zip Code:48433-2020
Mailing Address - Country:US
Mailing Address - Phone:810-487-9733
Mailing Address - Fax:810-867-4938
Practice Address - Street 1:209 S CHERRY ST
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:MI
Practice Address - Zip Code:48433-2020
Practice Address - Country:US
Practice Address - Phone:810-487-9733
Practice Address - Fax:810-867-4938
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-18
Last Update Date:2020-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI551017928261QP2000X
MI55010179282251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Multi-Specialty
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI5501017928OtherSTATE LICENSE