Integrated Therapy and Diagnostics,LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

D0637C Issued in MI

Legal business name

INTEGRATED THERAPY AND DIAGNOSTICS,LLC

Practice address

23077 Greenfield Rd Ste 110
Southfield, MI 48075-3744

Phone

(248) 569-3002

NPI assigned

Jan 30, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Brandon L Jones

Title

Director

Phone

(734) 645-0399

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1255478459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753744",
            "telephone_number": "248-569-3002",
            "fax_number": "248-569-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23077 GREENFIELD RD STE 110",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480753744",
            "telephone_number": "248-569-3002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED THERAPY AND DIAGNOSTICS,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "BRANDON",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "734-645-0399",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "D0637C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Therapy Clinic/Center in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.