Healthcare Provider Details

I. General information

NPI: 1841994480
Provider Name (Legal Business Name): REHAB & AUTO INJURY MESSAGE OF MICHIGAN, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/28/2023
Last Update Date: 03/28/2023
Certification Date: 03/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15255 PEBBLEBROOK DR
BELLEVILLE MI
48111
US

IV. Provider business mailing address

15255 PEBBLEBROOK DR
BELLEVILLE MI
48111
US

V. Phone/Fax

Practice location:
  • Phone: 734-645-4294
  • Fax: 989-573-8131
Mailing address:
  • Phone: 734-645-4294
  • Fax: 989-573-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. ROBERT WIEDLING JR.
Title or Position: OWNER
Credential:
Phone: 734-645-4294