Provider Demographics
NPI:1477362622
Name:RESTORE & PERFORM PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:RESTORE & PERFORM PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SARA
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:734-259-2701
Mailing Address - Street 1:12306 HOWLAND PARK DR
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-2892
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:833-339-5998
Practice Address - Street 1:23955 FREEWAY PARK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48335-2817
Practice Address - Country:US
Practice Address - Phone:734-259-2701
Practice Address - Fax:833-339-5998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-02
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty