Provider Demographics
NPI:1457102758
Name:STAY WELL PHYSICAL THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:STAY WELL PHYSICAL THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:
Authorized Official - Last Name:OROW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:586-808-1106
Mailing Address - Street 1:2745 PINE RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1960
Mailing Address - Country:US
Mailing Address - Phone:586-808-1106
Mailing Address - Fax:
Practice Address - Street 1:300 E 12 MILE RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-2531
Practice Address - Country:US
Practice Address - Phone:586-808-1106
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-27
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty