Organization
ST MARY PHYSICAL THERAPY AND REHABILITATION LLC
Active
Organization
ST MARY PHYSICAL THERAPY AND REHABILITATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SAMI FALTAS PT (OWNER)
(248) 739-9059
Entity
Organization
Contact information
Practice address
20825 MACK AVE, GROSSE POINTE WOODS, MI 48236-1485
(248) 739-9059
Mailing address
11258 REGAL DR, STERLING HEIGHTS, MI 48313-4974
(248) 739-9059
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
5501008309
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
650F329970
BLUE SHIELD OF MICHIGAN
MI
Enumeration date
03/12/2008
Last updated
02/04/2011
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