Healthcare Provider Details

I. General information

NPI: 1154372746
Provider Name (Legal Business Name): LMT REHABILITATION ASSOCIATES,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/23/2021
Certification Date: 07/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3535 W 13 MILE RD STE 437
ROYAL OAK MI
48073-6710
US

IV. Provider business mailing address

3535 W 13 MILE RD SUITE 437
ROYAL OAK MI
48073-6710
US

V. Phone/Fax

Practice location:
  • Phone: 248-288-2210
  • Fax: 248-589-9875
Mailing address:
  • Phone: 248-616-1170
  • Fax: 248-589-9875

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: AMY W THOMAS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 248-616-1170