Healthcare Provider Details

I. General information

NPI: 1255355871
Provider Name (Legal Business Name): REHABILITATION SPECIALISTS OF MONROE P C
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/27/2006
Last Update Date: 12/07/2023
Certification Date: 12/07/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

905 N MACOMB ST STE 3
MONROE MI
48162-3076
US

IV. Provider business mailing address

905 N MACOMB ST STE 3
MONROE MI
48162-3076
US

V. Phone/Fax

Practice location:
  • Phone: 734-241-0560
  • Fax: 734-241-3230
Mailing address:
  • Phone: 734-241-0560
  • Fax: 734-241-3230

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number5101008796
License Number StateMI

VIII. Authorized Official

Name: DR. KEITH ROYDON BARBOUR
Title or Position: PRESIDENT/OWNER
Credential: D.O.
Phone: 734-241-0560