Organization
DYNASTY PHYSICAL THERPAY AND REHABILITATION, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TARIQ J. SIDDIQI PT (OWNER)
(313) 832-8008
Entity
Organization
Contact information
Practice address
3800 WOODWARD AVE STE 1100, DETROIT, MI 48201-2062
(313) 832-8008
Mailing address
3800 WOODWARD AVE STE 1100, DETROIT, MI 48201-2062
(313) 832-8008
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5501011025
MI
225X00000X
Occupational Therapist
5201006743
MI
Other
Enumeration date
10/31/2007
Last updated
10/31/2007
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