Provider Demographics
NPI:1063381903
Name:ZOMA PHYSICAL THERAPY PLLC
Entity type:Organization
Organization Name:ZOMA PHYSICAL THERAPY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:
Authorized Official - Last Name:ZOMA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-464-4044
Mailing Address - Street 1:6817 LONG AVE
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-1249
Mailing Address - Country:US
Mailing Address - Phone:248-464-4044
Mailing Address - Fax:
Practice Address - Street 1:5839 W MAPLE RD STE 125
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-2278
Practice Address - Country:US
Practice Address - Phone:248-464-4044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-10-30
Last Update Date:2025-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty