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Organization

PERSONALIZE ADVANCE THERAPY SERVICES

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARLON A BURT (ADMINISTRATOR)
(313) 304-4040
Entity
Organization

Contact information

Practice address
4777 E OUTER DR FL GE, DETROIT, MI 48234-3241
(313) 304-4040
Mailing address
28021 SOUTHFIELD RD STE 200, LATHRUP VILLAGE, MI 48076-2816
(313) 304-4040

Taxonomy

Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary

Other

Enumeration date
02/10/2020
Last updated
02/10/2020
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