Healthcare Provider Details

I. General information

NPI: 1487899811
Provider Name (Legal Business Name): EURO REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2008
Last Update Date: 12/15/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11828 JOS CAMPAU ST
HAMTRAMCK MI
48212-3049
US

IV. Provider business mailing address

11828 JOS CAMPAU ST
HAMTRAMCK MI
48212-3049
US

V. Phone/Fax

Practice location:
  • Phone: 313-891-0505
  • Fax: 313-891-6070
Mailing address:
  • Phone: 313-891-0505
  • Fax: 313-891-6070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5501004579
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code261QP2000X
TaxonomyPhysical Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. MIKOLAJ LODZINSKI
Title or Position: ADMINISTRATOR
Credential:
Phone: 313-891-0505