Personalize Advance Therapy Services
Clinic/Center, Physical Therapy in Detroit, MI. Organization (NPI-2).
NPI number1962034710
StatusActive
Last updated in NPPESFeb 10, 2020
Details
- NPI
- 1962034710
- Entity type
- Organization (NPI-2)
- Legal business name
- Personalize Advance Therapy Services
- Organization subpart
- No
- Enumeration date
- Feb 10, 2020
- Certification date
- Feb 10, 2020
- Last updated
- Feb 10, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2000X | Clinic/Center, Physical Therapy | – | – | Yes |
Practice location
4777 E Outer Dr Fl GeDetroit, MI 48234-3241
Phone 313-304-4040
Mailing address
28021 Southfield Rd Ste 200Lathrup Village, MI 48076-2816
Phone 313-304-4040
Authorized official
Marlon A Burt
Administrator
3133044040
Is something wrong?
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