Provider Demographics
NPI:1285973560
Name:UNITED PHYSICAL THERAPY LLC
Entity type:Organization
Organization Name:UNITED PHYSICAL THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHADI
Authorized Official - Middle Name:
Authorized Official - Last Name:KAAFARANI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:313-405-3634
Mailing Address - Street 1:23300 GREENFIELD RD
Mailing Address - Street 2:STE 105
Mailing Address - City:OAK PARK
Mailing Address - State:MI
Mailing Address - Zip Code:48237-5237
Mailing Address - Country:US
Mailing Address - Phone:248-967-1900
Mailing Address - Fax:
Practice Address - Street 1:23300 GREENFIELD RD
Practice Address - Street 2:STE 105
Practice Address - City:OAK PARK
Practice Address - State:MI
Practice Address - Zip Code:48237-5237
Practice Address - Country:US
Practice Address - Phone:248-967-1900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009393261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy