MEDICARE: ADVANCED PHYSICAL REHABILITATION LUKAS PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1083730261
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ADVANCED PHYSICAL REHABILITATION LUKAS PLLC

Provider Business Mailing Address
First Line	:	3041 COMMERCE DR STE A
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-3820
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3041 COMMERCE DR STE A
Second Line	:
City	:	FORT GRATIOT
State	:	MI
Zip	:	48059-3820
Country	:	US
Telephone Number	:	248-385-7400
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	TIM LUKAS
Credential	:
Telephone Number	:	313-587-3168

Provider Enumeration Date	:	03/21/2007
Last Update Date	:	08/29/2007

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