Physio Matrix Inc.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501012446 Issued in MI

Legal business name

PHYSIO MATRIX INC.

Practice address

15841 W Warren Ave
Detroit, MI 48228-3737

Phone

(313) 846-9250

Fax

(313) 846-9325

NPI assigned

Jul 31, 2006

Last updated

Dec 3, 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

Naim M Khanafer

Title

President

Phone

(313) 846-9250

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1548275993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15841 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283737",
            "telephone_number": "313-846-9250",
            "fax_number": "313-846-9325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15841 W WARREN AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482283737",
            "telephone_number": "313-846-9250",
            "fax_number": "313-846-9325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO MATRIX INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "KHANAFER",
        "authorized_official_first_name": "NAIM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "313-846-9250"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501012446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Detroit, MI
• Providers in Detroit, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.