Provider Demographics
NPI:1982416400
Name:HARSEN PHYSICAL THERAPY AND PERFORMANCE TRAINING PLLC
Entity type:Organization
Organization Name:HARSEN PHYSICAL THERAPY AND PERFORMANCE TRAINING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:HARSEN
Authorized Official - Suffix:
Authorized Official - Credentials:PT, DPT
Authorized Official - Phone:586-383-0812
Mailing Address - Street 1:7707 FLICKINGER DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48317-2339
Mailing Address - Country:US
Mailing Address - Phone:586-383-0812
Mailing Address - Fax:
Practice Address - Street 1:2061 25 MILE RD
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48316-0941
Practice Address - Country:US
Practice Address - Phone:248-710-3236
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy