Healthcare Provider Details

I. General information

NPI: 1487796504
Provider Name (Legal Business Name): MEDICAL REHABILITATION PHYSICIANS PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/13/2007
Last Update Date: 10/02/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6079 W. MAPLE RD. STE. 100B
WEST BLOOMFIELD MI
48322
US

IV. Provider business mailing address

2935 HEALTH PARKWAY
MT PLEASANT MI
48858
US

V. Phone/Fax

Practice location:
  • Phone: 989-772-1609
  • Fax: 989-773-6279
Mailing address:
  • Phone: 989-772-1609
  • Fax: 989-773-6279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCC087757
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code111NR0400X
TaxonomyRehabilitation Chiropractor
License NumberMB009073
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License NumberMB064477
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberMB064477
License Number StateMI

VIII. Authorized Official

Name: MRS. MARVIN N. BLEIBERG
Title or Position: PRESIDENT/OWNER
Credential: MD
Phone: 989-772-1609