Healthcare Provider Details

I. General information

NPI: 1902006158
Provider Name (Legal Business Name): AXIOM PHYSICAL THERAPY & REHABILITATION CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18254 LIVERNOIS AVE
DETROIT MI
48221-4214
US

IV. Provider business mailing address

18254 LIVERNOIS AVE
DETROIT MI
48221-4214
US

V. Phone/Fax

Practice location:
  • Phone: 313-329-3977
  • Fax:
Mailing address:
  • Phone: 313-329-3977
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ASIF MAJEED CHAUDHRY
Title or Position: ADMIN
Credential:
Phone: 313-329-3977