Provider Demographics
NPI:1295805984
Name:HANDS ON PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:HANDS ON PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:STEFAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NEDELA
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-593-8677
Mailing Address - Street 1:36880 WOODWARD AVE
Mailing Address - Street 2:SUITE 104
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-0919
Mailing Address - Country:US
Mailing Address - Phone:248-593-8677
Mailing Address - Fax:248-593-8683
Practice Address - Street 1:36880 WOODWARD AVE
Practice Address - Street 2:SUITE 104
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-0919
Practice Address - Country:US
Practice Address - Phone:248-593-8677
Practice Address - Fax:248-593-8683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2010-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MISN008896225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI650F335540OtherBCBS
MI0P38940Medicare ID - Type Unspecified
MI650F335540OtherBCBS