Provider Demographics
NPI:1144268046
Name:PERRY PHYSICAL THERAPY INC
Entity type:Organization
Organization Name:PERRY PHYSICAL THERAPY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:STACEY
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, PT
Authorized Official - Phone:517-625-0772
Mailing Address - Street 1:3737 BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:MI
Mailing Address - Zip Code:48872-9716
Mailing Address - Country:US
Mailing Address - Phone:517-625-0772
Mailing Address - Fax:517-625-0778
Practice Address - Street 1:3737 BRITTON RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:MI
Practice Address - Zip Code:48872-9716
Practice Address - Country:US
Practice Address - Phone:517-625-0772
Practice Address - Fax:517-625-0778
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-03
Last Update Date:2016-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
0N68780Medicare PIN
MI0N68780Medicare PIN