Organization
SELECT PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ESRAA MOUSA (OWNER)
(313) 715-7152
Entity
Organization
Contact information
Practice address
6558 GREENFIELD RD, DEARBORN, MI 48126-1701
(313) 715-7152
Mailing address
6558 GREENFIELD RD, DEARBORN, MI 48126-1701
(313) 715-7152
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MI
Enumeration date
12/27/2018
Last updated
12/27/2018
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