Provider Demographics
NPI:1134209430
Name:TRI-CITY PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:TRI-CITY PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:TAHZIBUL
Authorized Official - Middle Name:H
Authorized Official - Last Name:RIZVI
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:734-667-5507
Mailing Address - Street 1:5976 NANEVA CT
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-2518
Mailing Address - Country:US
Mailing Address - Phone:734-667-5507
Mailing Address - Fax:734-667-5508
Practice Address - Street 1:8552 N CANTON CENTER RD
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MI
Practice Address - Zip Code:48187-1310
Practice Address - Country:US
Practice Address - Phone:734-667-5507
Practice Address - Fax:734-667-5508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-17
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy