Provider Demographics
NPI:1699879973
Name:PHYSIOTHERAPY ASSOCIATES INC
Entity type:Organization
Organization Name:PHYSIOTHERAPY ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CONTRACTING
Authorized Official - Prefix:
Authorized Official - First Name:ROB
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIGENFUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:901-685-7227
Mailing Address - Street 1:26 N STATE ST
Mailing Address - Street 2:SUITE 500
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-1281
Mailing Address - Country:US
Mailing Address - Phone:616-748-1140
Mailing Address - Fax:616-748-1150
Practice Address - Street 1:26 N STATE ST
Practice Address - Street 2:SUITE 500
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-1281
Practice Address - Country:US
Practice Address - Phone:616-748-1140
Practice Address - Fax:616-748-1150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-08
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI=========OtherTAX ID
MI=========OtherTAX ID