Provider Demographics
NPI:1750542924
Name:TOTAL HEALTH PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:TOTAL HEALTH PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:PIOTR
Authorized Official - Middle Name:
Authorized Official - Last Name:KASPRZYK
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:586-949-0123
Mailing Address - Street 1:28098 23 MILE RD
Mailing Address - Street 2:STE 103
Mailing Address - City:CHESTERFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48051-2316
Mailing Address - Country:US
Mailing Address - Phone:586-949-0123
Mailing Address - Fax:586-228-9019
Practice Address - Street 1:28098 23 MILE RD
Practice Address - Street 2:STE 103
Practice Address - City:CHESTERFIELD
Practice Address - State:MI
Practice Address - Zip Code:48051-2316
Practice Address - Country:US
Practice Address - Phone:586-949-0123
Practice Address - Fax:586-228-9019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-20
Last Update Date:2008-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIPK007825225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty