Organization
411 PT INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIRNA FAYAD (OWNER)
(313) 850-7888
Entity
Organization
Contact information
Practice address
19201 W WARREN AVE, DETROIT, MI 48228-3393
(248) 996-9428
Mailing address
23265 NORTHWESTERN HWY, SOUTHFIELD, MI 48075-7707
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
08/03/2021
Last updated
07/28/2022
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