Provider Demographics
NPI:1932981446
Name:MICHIGAN FYZPT-I LLC
Entity Type:Organization
Organization Name:MICHIGAN FYZPT-I LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NAFSO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-939-3969
Mailing Address - Street 1:43155 MAIN ST STE 2310C
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-1799
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:43155 MAIN ST STE 2310C
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48375-1799
Practice Address - Country:US
Practice Address - Phone:248-826-5600
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-18
Last Update Date:2023-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy