Provider Demographics
NPI:1487871448
Name:UNIVERSAL PHYSICAL THERAPY,PC
Entity type:Organization
Organization Name:UNIVERSAL PHYSICAL THERAPY,PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:EMAD
Authorized Official - Middle Name:ABDELATI
Authorized Official - Last Name:ELMARAKBY
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:248-844-2644
Mailing Address - Street 1:6316 BROOKINGS DR
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48098-1862
Mailing Address - Country:US
Mailing Address - Phone:248-879-7510
Mailing Address - Fax:248-844-2645
Practice Address - Street 1:2565 S ROCHESTER RD # A
Practice Address - Street 2:
Practice Address - City:ROCHESTER HILLS
Practice Address - State:MI
Practice Address - Zip Code:48307-4472
Practice Address - Country:US
Practice Address - Phone:248-844-2644
Practice Address - Fax:248-844-2645
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501007293225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty