Provider Demographics
NPI:1649862368
Name:MICHIGAN PEDIATRIC THERAPY PLC
Entity type:Organization
Organization Name:MICHIGAN PEDIATRIC THERAPY PLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:MAGDA
Authorized Official - Middle Name:
Authorized Official - Last Name:GIRAO
Authorized Official - Suffix:
Authorized Official - Credentials:OTR
Authorized Official - Phone:248-939-4030
Mailing Address - Street 1:7369 SWEETBRIAR
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48324-2553
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:27655 MIDDLEBELT RD STE 130
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48334-5029
Practice Address - Country:US
Practice Address - Phone:248-939-4030
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-04
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatricsGroup - Single Specialty