MEDICARE: JOSEPH LABIB DPT

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	225100000X	Physical Therapist	5501011866	MI

General Provider Information

NPI Number	:	1740582410
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH LABIB DPT

Provider Business Mailing Address
First Line	:	28051 DEQUINDRE RD STE A
Second Line	:
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3016
Country	:	US
Telephone Number	:	248-629-4011
Fax Number	:	248-629-4010

Provider Business Practice Location Address
First Line	:	28051 DEQUINDRE RD
Second Line	:	SUITE A.
City	:	MADISON HEIGHTS
State	:	MI
Zip	:	48071-3016
Country	:	US
Telephone Number	:	248-629-4011
Fax Number	:	248-629-4010

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2010
Last Update Date	:	04/07/2020

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