Organization
FASTBACK PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE WENINGER (CREDENTIALING SPECIALIST)
(248) 601-9207
Entity
Organization
Contact information
Practice address
3333 S SUNNYSLOPE RD STE 103B, NEW BERLIN, WI 53151-4504
(262) 853-8452
Mailing address
1773 STAR BATT DR, ROCHESTER HILLS, MI 48309-3708
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
10/30/2018
Last updated
08/06/2024
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