Organization
FUNCTIONAL PHYSICAL THERAPY OF CLARKSTON
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KORNELIS OOSTHEK PT (DIRECTOR)
(248) 620-1415
Entity
Organization
Contact information
Practice address
7736 ORTONVILLE RD STE C, CLARKSTON, MI 48348-4483
(248) 620-1415
Mailing address
4206 PONTIAC LAKE RD, WATERFORD, MI 48328-1261
(248) 673-6980
(248) 673-7497
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
04/04/2007
Last updated
08/22/2020
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