Provider Demographics
NPI:1285954107
Name:POINTE PHYSICAL THERAPY
Entity type:Organization
Organization Name:POINTE PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:GIGI
Authorized Official - Middle Name:
Authorized Official - Last Name:JOHN
Authorized Official - Suffix:
Authorized Official - Credentials:RPT
Authorized Official - Phone:586-774-5006
Mailing Address - Street 1:17200 E 10 MILE RD STE 130
Mailing Address - Street 2:
Mailing Address - City:EASTPOINTE
Mailing Address - State:MI
Mailing Address - Zip Code:48021-3349
Mailing Address - Country:US
Mailing Address - Phone:586-774-5006
Mailing Address - Fax:
Practice Address - Street 1:17200 E 10 MILE RD STE 130
Practice Address - Street 2:
Practice Address - City:EASTPOINTE
Practice Address - State:MI
Practice Address - Zip Code:48021-3349
Practice Address - Country:US
Practice Address - Phone:586-774-5006
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-02
Last Update Date:2010-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty