Provider Demographics
NPI:1427757459
Name:CONVERGENT KINETICS, PLLC
Entity type:Organization
Organization Name:CONVERGENT KINETICS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ATHENA
Authorized Official - Middle Name:
Authorized Official - Last Name:AKRAM
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-993-5526
Mailing Address - Street 1:25155 SPRINGBROOK DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48336-1953
Mailing Address - Country:US
Mailing Address - Phone:248-993-5526
Mailing Address - Fax:
Practice Address - Street 1:25155 SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48336-1953
Practice Address - Country:US
Practice Address - Phone:248-993-5526
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomicsGroup - Multi-Specialty