Organization
UZNIS PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANE A CARVELL PT (PHYSICAL THERAPIST)
(313) 881-5678
Entity
Organization
Contact information
Practice address
18101 E WARREN AVE, DETROIT, MI 48224-1382
(313) 881-5678
(313) 881-9337
Mailing address
3620 BETSY ROSS DR, ROYAL OAK, MI 48073-6400
(248) 549-6407
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5501001604
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0094960002
—
MI
01
—
30392
BLUE CROSS
—
Enumeration date
04/19/2007
Last updated
08/22/2020
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