MEDICARE: ALLTIMATE REHAB SOLUTIONS LLC

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	225X00000X	Occupational Therapist
2	225100000X	Physical Therapist

General Provider Information

NPI Number	:	1144869405
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLTIMATE REHAB SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	2111 MERRITT RD STE 103
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-6916
Country	:	US
Telephone Number	:	586-822-0007
Fax Number	:	586-933-8044

Provider Business Practice Location Address
First Line	:	39880 VAN DYKE AVE STE 201
Second Line	:
City	:	STERLING HEIGHTS
State	:	MI
Zip	:	48313-4670
Country	:	US
Telephone Number	:	586-822-0007
Fax Number	:	586-933-8044

Authorized Official
Title or Position	:	MEMBER
Name	:	KAUSHIKKUMAR PATEL
Credential	:	P.T.
Telephone Number	:	586-822-0007

Provider Enumeration Date	:	01/03/2020
Last Update Date	:	06/04/2020

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Directions to “ALLTIMATE REHAB SOLUTIONS LLC ” Practice Location

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