Clarkston Physical Therapy and Rehabilitation Center

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

236761 Issued in MI

Legal business name

CLARKSTON PHYSICAL THERAPY AND REHABILITATION CENTER

Practice address

18272 Livernois Ave
Detroit, MI 48221-2773

Phone

(313) 862-1419

Fax

(313) 862-2476

NPI assigned

Apr 23, 2007

Last updated

Aug 16, 2013By 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

Mr. Asif M Chaudhry, PT

Title

Administrator

Phone

(313) 862-1419

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376611200000",
    "number": "1932327327",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18272 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212773",
            "telephone_number": "313-862-1419",
            "fax_number": "313-862-2476"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18272 LIVERNOIS AVE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482212773",
            "telephone_number": "313-862-1419",
            "fax_number": "313-862-2476"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLARKSTON PHYSICAL THERAPY AND REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2013-08-16",
        "status": "A",
        "authorized_official_last_name": "CHAUDHRY",
        "authorized_official_first_name": "ASIF",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-862-1419",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "MI",
            "license": "236761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OPT",
            "identifier": "236761/ 1932327327",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tenora Clark
• Tony Milton Clark
• Vicki Marie Clark, RN
• Yameka Clark
• Anthony W Clarke, M.D.
• Carol Classen
• Nicole Roberta Claudin, NURSE PRACTITIONER
• Claudio Holdings LLC (Detroit Eyecare)
• Claudio Holdings LLC (Detroit Eyecare)
• David Jacob Clausen, MD

• 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 Aug 16, 2013; 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.