Provider Demographics
NPI:1518692821
Name:RESURGENCE PHYSICAL THERAPY SERVICES PC
Entity type:Organization
Organization Name:RESURGENCE PHYSICAL THERAPY SERVICES PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NIMESH
Authorized Official - Middle Name:
Authorized Official - Last Name:SETH
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:734-834-1667
Mailing Address - Street 1:2258 PLUMGROVE LN
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-1465
Mailing Address - Country:US
Mailing Address - Phone:734-834-1667
Mailing Address - Fax:
Practice Address - Street 1:6525 W MAPLE RD
Practice Address - Street 2:SUITE A
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4930
Practice Address - Country:US
Practice Address - Phone:248-562-7846
Practice Address - Fax:248-562-7858
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-20
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty