Organization
LEGACY PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ROGER WILLIAM GOBLE (OWNER)
(248) 885-2305
Entity
Organization
Contact information
Practice address
9299 GOBLE, BRIGHTON, MI 48116-8700
(248) 885-2302
Mailing address
3859 HIGHCREST DR, BRIGHTON, MI 48116-7705
(248) 885-2305
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
01/16/2019
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