Healthcare Provider Details

I. General information

NPI: 1497195531
Provider Name (Legal Business Name): REHAB SERVICE CONSULTANTS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2013
Last Update Date: 07/03/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1611 MONROE ST
DEARBORN MI
48124-2912
US

IV. Provider business mailing address

27208 SOUTHFIELD RD STE 7
LATHRUP VILLAGE MI
48076-7912
US

V. Phone/Fax

Practice location:
  • Phone: 313-278-7100
  • Fax:
Mailing address:
  • Phone:
  • 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: MAREK GAUL
Title or Position: ADMINISTRATOR
Credential:
Phone: 313-278-7100