Provider Demographics
NPI:1669159422
Name:EXPERT CARE PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:EXPERT CARE PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KAMINI
Authorized Official - Middle Name:
Authorized Official - Last Name:KOMARRAJU
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:586-764-3543
Mailing Address - Street 1:43754 SWEETWOOD DR
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48314-4509
Mailing Address - Country:US
Mailing Address - Phone:586-764-3543
Mailing Address - Fax:
Practice Address - Street 1:6780 ROCHESTER RD
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48085-1283
Practice Address - Country:US
Practice Address - Phone:586-764-3543
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty