Spine and Extremity Institute of South Lyon, L.l.c.
NPI #1811209968 in South Lyon, Michigan
Provider Information
- NPI Number
- 1811209968
- Entity Type
- Organization
- Organization Name
- Spine and Extremity Institute of South Lyon, L.l.c.
- Primary Specialty
- Physical Therapist
- Enumeration Date
- Jul 6, 2010
- Last Updated
- Jul 6, 2010
Practice Location
- Address
- 22180 PONTIAC TRAIL
- Address 2
- SUITE E
- City
- South Lyon
- State
- Michigan
- ZIP Code
- 48178-9097
- Phone
- (248) 446-0155
Authorized Official
- Name
- MR. MATTHEW ALEXANDER BROSTROM, MPT, CERT. MDT
- Title
- OWNER/DIRECTOR OF PHYSICAL THERAPY
- Phone
- (248) 446-0155
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physical Therapist |
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