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Organization
QUANTUM PHYSICAL THERAPY LLC
Active
Organization
QUANTUM PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIZIANO MAROVINO P.T. (OWNER)
(734) 483-9200
Entity
Organization
Contact information
Practice address
1613 S HURON ST, YPSILANTI, MI 48197-9701
(734) 483-9200
(734) 483-9202
Mailing address
1613 S HURON ST, YPSILANTI, MI 48197-9701
(734) 483-9200
(734) 483-9202
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501004580
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0H10432
BCBSM
MI
01
—
0H11582
BCBSM
MI
Enumeration date
10/03/2006
Last updated
12/29/2011
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