Provider Demographics
NPI:1932988326
Name:HEALTHY PHYSICAL THERAPY LLC
Entity Type:Organization
Organization Name:HEALTHY PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:YOUSIF
Authorized Official - Middle Name:
Authorized Official - Last Name:AFAN
Authorized Official - Suffix:
Authorized Official - Credentials:OWNER
Authorized Official - Phone:248-291-4648
Mailing Address - Street 1:37824 VAN DYKE AVE STE B
Mailing Address - Street 2:
Mailing Address - City:STERLING HEIGHTS
Mailing Address - State:MI
Mailing Address - Zip Code:48312-1840
Mailing Address - Country:US
Mailing Address - Phone:248-291-4648
Mailing Address - Fax:586-999-8881
Practice Address - Street 1:37824 VAN DYKE AVE STE B
Practice Address - Street 2:
Practice Address - City:STERLING HEIGHTS
Practice Address - State:MI
Practice Address - Zip Code:48312-1840
Practice Address - Country:US
Practice Address - Phone:248-291-4648
Practice Address - Fax:586-999-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-25
Last Update Date:2024-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty