411 PT Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

411 PT INC

Practice address

19201 W Warren Ave
Detroit, MI 48228-3393

Phone

(248) 996-9428

NPI assigned

Aug 3, 2021

Last updated

Jul 28, 2022By 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

Mirna Fayad

Title

Owner

Phone

(313) 850-7888

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658966400000",
    "number": "1437823465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23265 NORTHWESTERN HWY",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480757707"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19201 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283393",
            "telephone_number": "248-996-9428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "411 PT INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-03",
        "last_updated": "2022-07-28",
        "certification_date": "2022-07-28",
        "status": "A",
        "authorized_official_last_name": "FAYAD",
        "authorized_official_first_name": "MIRNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "313-850-7888"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Detroit, MI
• Providers in Detroit, 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 Jul 28, 2022; 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.