Healthcare Provider Details

I. General information

NPI: 1851458608
Provider Name (Legal Business Name): THERAMAX REHAB, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 11/05/2024
Certification Date: 11/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 GRAND HAVEN DR
TROY MI
48083-4418
US

IV. Provider business mailing address

3381 HIDDEN OAKS LN
WEST BLOOMFIELD MI
48324-3256
US

V. Phone/Fax

Practice location:
  • Phone: 586-335-8182
  • Fax: 248-757-2330
Mailing address:
  • Phone: 586-335-8182
  • Fax: 248-779-7543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2251G0304X
TaxonomyGeriatric Physical Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code225XG0600X
TaxonomyGerontology Occupational Therapist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number
License Number State

VIII. Authorized Official

Name: GULSHAN CHANDNA
Title or Position: OWNER
Credential:
Phone: 248-417-3646