Organization
DERY PHYSICAL THERAPY SERVICES, PC
Active
Organization
DERY PHYSICAL THERAPY SERVICES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CASIMIR A KILYANEK PT (PRESIDENT)
(616) 897-7055
Entity
Organization
Contact information
Practice address
901 W MAIN ST, SUITE A, LOWELL, MI 49331-1581
(616) 897-7055
(616) 897-7366
Mailing address
901 W MAIN ST, SUITE A, LOWELL, MI 49331-1581
(616) 897-7055
(616) 897-7366
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30732
BCSBM NUMBER
MI
Enumeration date
01/29/2007
Last updated
02/03/2017
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