Healthcare Provider Details

I. General information

NPI: 1558691287
Provider Name (Legal Business Name): THERMOTIC REHAB SERVICES INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/31/2009
Last Update Date: 12/31/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17555 JAMES COUZENS FWY STE 1
DETROIT MI
48235-2657
US

IV. Provider business mailing address

17555 JAMES COUZENS FWY STE 1
DETROIT MI
48235-2657
US

V. Phone/Fax

Practice location:
  • Phone: 313-862-2226
  • Fax: 313-862-2229
Mailing address:
  • Phone: 313-862-2226
  • Fax: 313-862-2229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5501007107
License Number StateMI

VIII. Authorized Official

Name: MR. ZAHIR SHAH
Title or Position: PHYSICAL THERAPIST
Credential: P.T.
Phone: 313-862-2226