Organization
FORM PHYSICAL THERAPY, LLC
Active
Organization
FORM PHYSICAL THERAPY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY ANN-TRIMMER DELIND DPT (PHYSICAL THERAPIST)
(248) 860-1329
Entity
Organization
Contact information
Practice address
22340 HARPER AVE, SAINT CLAIR SHORES, MI 48080-1818
(586) 330-0499
Mailing address
22340 HARPER AVE, SAINT CLAIR SHORES, MI 48080-1818
(586) 330-0499
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/08/2019
Last updated
04/08/2019
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