Healthcare Provider Details

I. General information

NPI: 1285651919
Provider Name (Legal Business Name): DWIGHT ORTHOPEDIC REHABILITATION CO
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/17/2006
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1432 E 12 MILE RD
MADISON HEIGHTS MI
48071
US

IV. Provider business mailing address

42615 GARFIELD RD
CLINTON TOWNSHIP MI
48038
US

V. Phone/Fax

Practice location:
  • Phone: 248-543-4886
  • Fax: 248-543-0879
Mailing address:
  • Phone: 586-412-2846
  • Fax: 586-286-0427

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM H DWIGHT
Title or Position: PT
Credential:
Phone: 248-866-4364