Healthcare Provider Details

I. General information

NPI: 1720207079
Provider Name (Legal Business Name): TOTAL REHAB SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 09/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35746 HARPER AVE
CLINTON TOWNSHIP MI
48035-3212
US

IV. Provider business mailing address

35746 HARPER AVE
CLINTON TOWNSHIP MI
48035-3212
US

V. Phone/Fax

Practice location:
  • Phone: 586-791-9203
  • Fax: 586-791-9204
Mailing address:
  • Phone: 586-791-9203
  • Fax: 586-791-9204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code224Z00000X
TaxonomyOccupational Therapy Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State

VIII. Authorized Official

Name: MR. BRENT HALL
Title or Position: PRESIDENT
Credential: MPT
Phone: 586-791-9203