Provider Demographics
NPI:1457022345
Name:REFINE PHYSICAL THERAPY AND WELLNESS, LLC
Entity Type:Organization
Organization Name:REFINE PHYSICAL THERAPY AND WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:TERESA
Authorized Official - Last Name:LORENZ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:734-658-6522
Mailing Address - Street 1:8489 KINGSLEY DR
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-1915
Mailing Address - Country:US
Mailing Address - Phone:734-658-6522
Mailing Address - Fax:734-545-8135
Practice Address - Street 1:44670 ANN ARBOR RD W STE 140
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-3962
Practice Address - Country:US
Practice Address - Phone:734-658-6522
Practice Address - Fax:734-545-8135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-09-21
Last Update Date:2023-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty