Organization
FUNCTIONAL FITNESS L L C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY HALE (OWNER)
(248) 988-8098
Entity
Organization
Contact information
Practice address
1185 S ADAMS RD, BIRMINGHAM, MI 48009-7101
(248) 988-8098
(248) 988-8583
Mailing address
1185 S ADAMS RD, BIRMINGHAM, MI 48009-7101
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
—
—
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
02/15/2008
Last updated
04/29/2009
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