Healthcare Provider Details

I. General information

NPI: 1508013376
Provider Name (Legal Business Name): MICHIGAN REHABILITATION SPECIALISTS HOUSE CALLS, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/25/2008
Last Update Date: 08/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10200 PROFESSIONAL CENTER DR. SUITE 200
HAMBURG MI
48139
US

IV. Provider business mailing address

PO BOX 215
HAMBURG MI
48139-0215
US

V. Phone/Fax

Practice location:
  • Phone: 810-231-6904
  • Fax:
Mailing address:
  • Phone: 810-231-6904
  • Fax: 810-231-6906

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: RODNEY P. GOBLE
Title or Position: CO-OWNER
Credential: MPT
Phone: 810-231-6904