Organization
ACTIVE OUTPATIENT THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STARVOS TOMA (PRESIDENT)
(248) 952-9052
Entity
Organization
Contact information
Practice address
520 E 12 MILE RD, SUITE - B, MADISON HEIGHTS, MI 48071-2517
(248) 952-9052
Mailing address
520 E 12 MILE RD, SUITE - B, MADISON HEIGHTS, MI 48071-2517
(248) 952-9052
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
02/04/2016
Last updated
02/04/2016
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