Provider Demographics
NPI:1336329747
Name:ALL-PRO PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:ALL-PRO PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:RAJIV
Authorized Official - Middle Name:PRAMOD
Authorized Official - Last Name:AMIN
Authorized Official - Suffix:
Authorized Official - Credentials:MPT
Authorized Official - Phone:734-953-4155
Mailing Address - Street 1:37699 6 MILE RD
Mailing Address - Street 2:200
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-3994
Mailing Address - Country:US
Mailing Address - Phone:734-953-4155
Mailing Address - Fax:734-953-1622
Practice Address - Street 1:37699 6 MILE RD
Practice Address - Street 2:SUITE 200
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48152-3994
Practice Address - Country:US
Practice Address - Phone:734-953-4155
Practice Address - Fax:734-953-1622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-14
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501010339225100000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
236813Medicare Oscar/Certification
MI0N26170Medicare PIN