Provider Demographics
NPI:1306391859
Name:PRO-MOTION PHYSICAL THERAPY OF HOWELL, PC
Entity type:Organization
Organization Name:PRO-MOTION PHYSICAL THERAPY OF HOWELL, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:MEKJIAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:734-765-3171
Mailing Address - Street 1:1225 W GRAND RIVER AVE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-3975
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1225 W GRAND RIVER AVE
Practice Address - Street 2:SUITE 200
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-3975
Practice Address - Country:US
Practice Address - Phone:734-765-3173
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty