Provider Demographics
NPI:1821507690
Name:LEVAN PHYSICAL THERAPY PLLC
Entity Type:Organization
Organization Name:LEVAN PHYSICAL THERAPY PLLC
Other - Org Name:WAYNE WESTLAND PHYSICAL THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ALKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GULATI
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:734-968-9206
Mailing Address - Street 1:18055 STONEBROOK DR
Mailing Address - Street 2:
Mailing Address - City:NORTHVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48168-4345
Mailing Address - Country:US
Mailing Address - Phone:734-968-9206
Mailing Address - Fax:
Practice Address - Street 1:15132 LEVAN RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154-5027
Practice Address - Country:US
Practice Address - Phone:734-968-9206
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-25
Last Update Date:2022-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy