Healthcare Provider Details

I. General information

NPI: 1952870412
Provider Name (Legal Business Name): ENIDA HUREMOVIC MOTRL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2018
Last Update Date: 11/14/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26001 FORD RD
DEARBORN HEIGHTS MI
48127-2920
US

IV. Provider business mailing address

26001 FORD RD
DEARBORN HEIGHTS MI
48127-2920
US

V. Phone/Fax

Practice location:
  • Phone: 313-274-4600
  • Fax:
Mailing address:
  • Phone: 313-274-4600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0019X
TaxonomyPhysical Rehabilitation Occupational Therapist
License Number5201009866
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: