Organization · NPI-2

Absolute Physical Therapy LLC

Preferred Provider Organization · Dearborn, MI

NPI number1083031108
StatusActive
Last updated in NPPESMar 26, 2014

Details

NPI
1083031108
Entity type
Organization (NPI-2)
Legal business name
Absolute Physical Therapy LLC
Organization subpart
No
Enumeration date
Mar 26, 2014
Last updated
Mar 26, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
305R00000X Preferred Provider Organization––Yes

Practice location

17000 Executive Drive Suite105
Dearborn, MI 48126

Phone 313-908-5196

Mailing address

17000 Executive Drive Suite105
Dearborn, MI 48126

Authorized official

Anthony Ruscingno
Sole Member
3139085196

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