John Carlo Agalo-Os

Individual provider Active NPI Physical Therapist · Redford, MI

NPI 1639593296 · NPPES record last updated Feb 18, 2014

Key facts

NPI
1639593296
Entity type
Individual (NPI type 1)
Primary specialty
Physical Therapist 225100000X
License
5501011938 (MI)
Practice address
25106 W 6 Mile Rd
Redford, MI 48240-2706
Phone
(313) 541-1172
NPI assigned
Feb 18, 2014
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5501011938MIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Community Home Health Care, Inc. Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501011938 MI Yes

Addresses

Primary practice location

25106 W 6 Mile Rd
Redford, MI 48240-2706

Mailing address

25106 W 6 Mile Rd
Redford, MI 48240-2706
Phone (313) 541-1172

Other providers in Redford, MI

All providers in Redford, MI · Physical Therapist in Michigan

Sources for this page

Verify at the official NPI Registry.