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Organization

LIFESPAN THERAPY & WELLNESS, LLC

Active
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Organization

LIFESPAN THERAPY & WELLNESS, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KATHERINE MARY WYBO M.P.T. (CO-OWNER)
(248) 765-3153
Entity
Organization

Contact information

Practice address
7457 SAWGRESS DR, WASHINGTON TOWNSHIP, MI 48094
(248) 765-3153
Mailing address
PO BOX 567, WASHINGTON, MI 48094-0567
(248) 765-3153

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
5501010802
MI
225100000X
Physical Therapist
5501010889
MI
225100000X
Physical Therapist
Primary
5501010900
MI

Other

Enumeration date
11/10/2008
Last updated
12/29/2008
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