Healthcare Provider Details

I. General information

NPI: 1215333877
Provider Name (Legal Business Name): DEARBORN THERAPY AND REHAB SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/10/2014
Last Update Date: 11/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4700 GREENFIELD RD LC
DEARBORN MI
48126-4124
US

IV. Provider business mailing address

4700 GREENFIELD RD LC
DEARBORN MI
48126-4124
US

V. Phone/Fax

Practice location:
  • Phone: 313-624-9470
  • Fax:
Mailing address:
  • Phone: 313-624-9470
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. TALAT IQBAL
Title or Position: PRESIDENT
Credential:
Phone: 313-624-9470