Physico PT, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PHYSICO PT, LLC

Practice address

6 Parklane Blvd Ste 100
Dearborn, MI 48126-4206

Phone

(313) 314-0090

Fax

(313) 314-0095

NPI assigned

Sep 20, 2022

Last updated

Sep 20, 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

Dr. Kallil Kazan, DC

Title

Owner/Member

Phone

(313) 314-0090

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1663632000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1663632000000",
    "number": "1851014401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD STE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264206",
            "telephone_number": "313-314-0090",
            "fax_number": "313-314-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6 PARKLANE BLVD STE 100",
            "city": "DEARBORN",
            "state": "MI",
            "postal_code": "481264206",
            "telephone_number": "313-314-0090",
            "fax_number": "313-314-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICO PT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-09-20",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A",
        "authorized_official_last_name": "KAZAN",
        "authorized_official_first_name": "KALLIL",
        "authorized_official_title_or_position": "OWNER/MEMBER",
        "authorized_official_telephone_number": "313-314-0090",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Taishawna Phillips
• Gerald Lee Philo Jr., PTA
• Phoenix Mind Psychology PLLC
• Phylinx
• Physical Therapy Specialists of Dearborn LLC
• Physio Care Rehab LLC
• Stephanie Marie Piazza, NURSE PRACTITIONER
• Picard Burgess Family Practice PC
• Damesha Pierce
• Nicole Pierce

• 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 Sep 20, 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.