Organization
GREAT LAKES PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICHI R MITTAL PT (PHYSICAL THERAPIST)
(248) 968-4470
Entity
Organization
Contact information
Practice address
23300 GREENFIELD RD, SUITE 105, OAK PARK, MI 48237-5237
(248) 968-4470
Mailing address
23300 GREENFIELD RD, SUITE 105, OAK PARK, MI 48237-5237
(248) 968-4470
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501013760
MI
Other
Enumeration date
09/03/2009
Last updated
04/13/2010
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