Dearborn Life Care Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

DEARBORN LIFE CARE PHYSICAL THERAPY, LLC

Practice address

6313 Schaefer Rd
Dearborn, MI 48126-2210

Phone

(313) 633-0963

Fax

(313) 791-7154

NPI assigned

Dec 19, 2018

Organization subpart

No

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

Authorized official

Name

Wendy Mahan

Title

Manager

Phone

(734) 341-3328

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1545177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552521600000",
    "number": "1780156448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6313 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262210",
            "telephone_number": "313-633-0963",
            "fax_number": "313-791-7154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6313 SCHAEFER RD",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481262210",
            "telephone_number": "313-633-0963",
            "fax_number": "313-791-7154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEARBORN LIFE CARE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-19",
        "last_updated": "2019-03-14",
        "status": "A",
        "authorized_official_last_name": "MAHAN",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "734-341-3328"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dearborn Internist P.C.
• Dearborn Kidney Center LLC
• Dearborn Medical & Rehabilitation Center
• Dearborn Medical Associates, P.C.
• Dearborn Medical Institute PC
• Dearborn Medical Supplies Inc
• Dearborn Medical Supply

• Physical Therapy Clinic/Center in Dearborn, MI
• Providers in Dearborn, 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 14, 2019; 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.