| Doctor Name: | DR. KENNETH PETER SOAVE |
| NPI Number: | 1043478134 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | P.T.,D.P.T |
| License Number: | 5501002412 |
| Business Practice Address: | 24255 W 13 Mile Rd Suite 100 Bingham Farms, MI - 480254320 |
| Business Phone Number: | 2489888085 |
| Business Fax Number: | 2489888565 |
| Mailing Address: | 24255 W 13 Mile Rd, Suite 100 BINGHAM FARMS |
| State: | MI |
| Postal Code: | 480254320 |
| Phone Number: | 2489888085 |
| Fax Number: | 2489888565 |
| NPI Enumeration Date: | 05/27/2008 |
| NPI Last Update Date: | 05/27/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251S0007X |
| License Number: | 5501002412 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Sports |
| Taxonomy Definition: | |