Provider Demographics
NPI:1831807130
Name:POWER HEALTH PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:POWER HEALTH PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MGR
Authorized Official - Prefix:
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:
Authorized Official - Last Name:SANDS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:786-525-2599
Mailing Address - Street 1:318 JOHN R RD STE 308
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4542
Mailing Address - Country:US
Mailing Address - Phone:248-238-8833
Mailing Address - Fax:
Practice Address - Street 1:32340 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:MADISON HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48071-1073
Practice Address - Country:US
Practice Address - Phone:248-238-8833
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-07
Last Update Date:2022-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy