Provider Demographics
NPI:1538767728
Name:ALLEN PHYSICAL THERAPY NOVI LLC
Entity type:Organization
Organization Name:ALLEN PHYSICAL THERAPY NOVI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:FRANCES
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:KUBACKI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:248-437-2322
Mailing Address - Street 1:321 PETTIBONE ST STE 104
Mailing Address - Street 2:
Mailing Address - City:SOUTH LYON
Mailing Address - State:MI
Mailing Address - Zip Code:48178-6000
Mailing Address - Country:US
Mailing Address - Phone:248-437-2322
Mailing Address - Fax:248-437-2433
Practice Address - Street 1:26850 PROVIDENCE PKWY STE 400
Practice Address - Street 2:
Practice Address - City:NOVI
Practice Address - State:MI
Practice Address - Zip Code:48374-1263
Practice Address - Country:US
Practice Address - Phone:248-468-4796
Practice Address - Fax:248-468-4793
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-11
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty