Organization
ACTIVE BACK SUPPORT SERVICES,LLC
Active
Other names
Active Back Center
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE D MAYER (OFFICE MANAGER)
(734) 582-9770
Entity
Organization
Contact information
Practice address
9389 HAGGERTY RD., PLYMOUTH, MI 48170
(734) 582-9770
(734) 582-9773
Mailing address
9389 HAGGERTY RD., PLYMOUTH, MI 48170
(734) 582-9770
(734) 582-9773
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501012727
MI
Other
Enumeration date
12/26/2006
Last updated
08/22/2020
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