Image Therapeutic Care LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5501006020 Issued in MI

Legal business name

IMAGE THERAPEUTIC CARE LLC

Practice address

25740 Arden Park Dr
Farmington Hills, MI 48336-1622

Phone

(313) 822-4220

Fax

(313) 822-4220

NPI assigned

Mar 19, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Gunasinghe P Hewage, PHYSICAL THERAPIST

Title

President

Phone

(313) 822-4220

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1363651200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1363651200000",
    "number": "1255673133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25740 ARDEN PARK DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25740 ARDEN PARK DR",
            "city": "FARMINGTON HILLS",
            "state": "MI",
            "postal_code": "483361622",
            "telephone_number": "313-822-4220",
            "fax_number": "313-822-4220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IMAGE THERAPEUTIC CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-19",
        "last_updated": "2013-03-19",
        "status": "A",
        "authorized_official_last_name": "HEWAGE",
        "authorized_official_first_name": "GUNASINGHE",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-822-4220",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "5501006020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Matthew Ikonen-Loskowski, LMT
• Avae'E Ilalio
• Laura Ilasin
• Samer Abrahem Ilayan, MD
• Belinda Imafidon
• Kaylee E Imbriglio
• Ammara Imdad
• Immediate Care Medical Center, PC
• Linda Immler
• Immune & Diagnostic Laboratory Inc.

• Physical Therapy Clinic/Center in Farmington Hills, MI
• Providers in Farmington Hills, 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 Mar 19, 2013; 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.