Provider Demographics
NPI:1356104475
Name:ROYCE PT AND HOLISTIC CARE
Entity type:Organization
Organization Name:ROYCE PT AND HOLISTIC CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATRINA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ROYCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-206-4948
Mailing Address - Street 1:1905 PAULINE BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5036
Mailing Address - Country:US
Mailing Address - Phone:734-206-4948
Mailing Address - Fax:734-205-0456
Practice Address - Street 1:1905 PAULINE BLVD STE C
Practice Address - Street 2:
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48103-5036
Practice Address - Country:US
Practice Address - Phone:734-206-4948
Practice Address - Fax:734-205-0456
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-01
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty