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22142 W 9 Mile Rd, Southfield, MI 48033-6007 | |
(313) 624-9900 | |
(313) 624-9901 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Physical Therapy |
Location | 22142 W 9 Mile Rd, Southfield, Michigan |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1376887141 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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225100000X | Physical Therapist | (* (Not Available)) | Secondary |
261QP2000X | Clinic/center - Physical Therapy | (* (Not Available)) | Primary |
Provider Name | Lovely A Simon |
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Provider Type | Practitioner - Physical Therapist In Private Practice |
Provider Identifiers | NPI Number: 1396928503 PECOS PAC ID: 2668557364 Enrollment ID: I20080305000315 |
Mailing Address | Practice Location Address |
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Po Box 3310, Southfield, MI 48037-3310 Ph: (313) 624-9900 | 22142 W 9 Mile Rd, Southfield, MI 48033-6007 Ph: (313) 624-9900 |