Provider Demographics
NPI:1699168336
Name:CRANBROOK PHYSICAL THERAPY, PLLC
Entity type:Organization
Organization Name:CRANBROOK PHYSICAL THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:TAFELSKI
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:248-309-8900
Mailing Address - Street 1:60 W BIG BEAVER RD
Mailing Address - Street 2:SUITE 125
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-3909
Mailing Address - Country:US
Mailing Address - Phone:248-309-8900
Mailing Address - Fax:248-550-0147
Practice Address - Street 1:60 W BIG BEAVER RD
Practice Address - Street 2:SUITE 125
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-3909
Practice Address - Country:US
Practice Address - Phone:248-309-8900
Practice Address - Fax:248-550-0147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-05
Last Update Date:2015-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty