Organization Name: | LEVEL 11 PHYSICAL THERAPY |
NPI Number: | 1730317785 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | BRIAN F SHERIDAN (MEMBER) |
Mailing Address: | 10293 Dixie Hwy Suite 0 Holly |
State: | MI US |
Postal Code: | 484429210 |
Phone Number: | 9892256384 |
Fax Number: | |
NPI Enumeration Date: | 06/29/2009 |
NPI Last Update Date: | 11/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QR0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Rehabilitation |
Taxonomy Definition: |