Provider Demographics
NPI:1265738058
Name:HEALTHSTYLES SERVICES, P.C.
Entity type:Organization
Organization Name:HEALTHSTYLES SERVICES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CORPORATE ADMINISTRATOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:GWYNLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:SWARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-412-2846
Mailing Address - Street 1:42615 GARFIELD RD
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48038-1653
Mailing Address - Country:US
Mailing Address - Phone:586-412-2845
Mailing Address - Fax:
Practice Address - Street 1:301 S LAFAYETTE ST
Practice Address - Street 2:
Practice Address - City:SOUTH LYON
Practice Address - State:MI
Practice Address - Zip Code:48178-1407
Practice Address - Country:US
Practice Address - Phone:248-486-1110
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-27
Last Update Date:2011-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1265738058Medicare Oscar/Certification