Provider Demographics
NPI:1790092773
Name:PHYSIOTHERAPY ALLIANCE INC
Entity Type:Organization
Organization Name:PHYSIOTHERAPY ALLIANCE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:IMTIAZ
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:QURESHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-808-3270
Mailing Address - Street 1:2700 VISSING PARK RD
Mailing Address - Street 2:OUTPATIENT SUITE
Mailing Address - City:JEFFERSONVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47130-5989
Mailing Address - Country:US
Mailing Address - Phone:248-808-3270
Mailing Address - Fax:
Practice Address - Street 1:2700 VISSING PARK RD
Practice Address - Street 2:OUTPATIENT SUITE
Practice Address - City:JEFFERSONVILLE
Practice Address - State:IN
Practice Address - Zip Code:47130-5989
Practice Address - Country:US
Practice Address - Phone:248-808-3270
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-11
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty