Healthcare Provider Details
I. General information
NPI: 1174698336
Provider Name (Legal Business Name): MEDICAL REHABILITATION PHYSICIANS PLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 11/22/2006
Last Update Date: 10/02/2024
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2935 HEALTH PARKWAY
MT PLEASANT MI
48858
US
IV. Provider business mailing address
2935 HEALTH PARKWAY
MT PLEASANT MI
48858
US
V. Phone/Fax
- Phone: 989-772-1609
- Fax: 989-773-6279
- Phone: 989-772-1609
- Fax: 989-773-6279
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | MB009073 |
| License Number State | MI |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | MB064477 |
| License Number State | MI |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2084P0800X |
| Taxonomy | Psychiatry Physician |
| License Number | HR077496 |
| License Number State | MI |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 225100000X |
| Taxonomy | Physical Therapist |
| License Number | |
| License Number State | MI |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 332B00000X |
| Taxonomy | Durable Medical Equipment & Medical Supplies |
| License Number | MB064477 |
| License Number State | MI |
VIII. Authorized Official
Name:
MARVIN
N
BLEIBERG
Title or Position: PRESIDENT/OWNER
Credential: M.D.
Phone: 989-772-1609