Provider Demographics
NPI:1497000830
Name:EXCELLENT CARE PHYSICAL THERAPY PC
Entity type:Organization
Organization Name:EXCELLENT CARE PHYSICAL THERAPY PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:AHMED
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMMAM
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:734-225-6551
Mailing Address - Street 1:19145 ALLEN RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:BROWNSTOWN TWP
Mailing Address - State:MI
Mailing Address - Zip Code:48183-6812
Mailing Address - Country:US
Mailing Address - Phone:734-225-6551
Mailing Address - Fax:734-225-6581
Practice Address - Street 1:19145 ALLEN RD
Practice Address - Street 2:SUITE 110
Practice Address - City:BROWNSTOWN TWP
Practice Address - State:MI
Practice Address - Zip Code:48183-6812
Practice Address - Country:US
Practice Address - Phone:734-225-6551
Practice Address - Fax:734-225-6581
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-23
Last Update Date:2021-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5501009407225100000X
261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty