Healthcare Provider Details

I. General information

NPI: 1932199098
Provider Name (Legal Business Name): ASSOCIATES IN PHYSICAL MEDICINE AND REHABILITATION PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/28/2005
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DR SUITE 2009
YPSILANTI MI
48197-1014
US

IV. Provider business mailing address

5333 MCAULEY DR SUITE 2009
YPSILANTI MI
48197-1014
US

V. Phone/Fax

Practice location:
  • Phone: 734-712-0050
  • Fax: 734-712-0055
Mailing address:
  • Phone: 734-712-0050
  • Fax: 734-712-0055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: JENNIFER L SOCOLA
Title or Position: BILLER
Credential:
Phone: 734-712-0086