Healthcare Provider Details

I. General information

NPI: 1467315606
Provider Name (Legal Business Name): INFINITY REHAB OF MI LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2025
Last Update Date: 12/04/2025
Certification Date: 11/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28935 SOUTHFIELD RD
LATHRUP VILLAGE MI
48076-2720
US

IV. Provider business mailing address

2935 SOUTHFIELD RD
LATHRUP VILLAGE MI
48076
US

V. Phone/Fax

Practice location:
  • Phone: 248-882-0794
  • Fax:
Mailing address:
  • Phone: 248-882-0794
  • 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: JORDAN DEHKO
Title or Position: MEMBER
Credential:
Phone: 248-882-0794