Provider Demographics
NPI:1871885640
Name:JOINT PHYSICAL THERAPY
Entity type:Organization
Organization Name:JOINT PHYSICAL THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SHANE
Authorized Official - Middle Name:
Authorized Official - Last Name:STANLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:734-335-6298
Mailing Address - Street 1:9305 N LILLEY RD
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170-4609
Mailing Address - Country:US
Mailing Address - Phone:734-335-6298
Mailing Address - Fax:734-335-6743
Practice Address - Street 1:9305 N LILLEY RD
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4609
Practice Address - Country:US
Practice Address - Phone:734-335-6298
Practice Address - Fax:734-335-6743
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy