Provider Demographics
NPI:1831946771
Name:AYRES PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:AYRES PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PHYSICAL THERAPIST
Authorized Official - Prefix:DR
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:AYRES
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:810-338-9513
Mailing Address - Street 1:50374 UPTOWN AVE UNIT 304
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MI
Mailing Address - Zip Code:48187-5919
Mailing Address - Country:US
Mailing Address - Phone:810-338-9513
Mailing Address - Fax:
Practice Address - Street 1:1047 S CASS LAKE RD
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:MI
Practice Address - Zip Code:48328-4509
Practice Address - Country:US
Practice Address - Phone:248-702-4502
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-04-30
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty