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General NPI Number Information
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NPI Number | 1043358393
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Entity Type | Organization
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Legal Business Name | MICHIGAN INSTITUTE OF REHABILITATIVE SERVICES, INC
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 09/09/2010
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Provider Practice Location Address
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Address Line | 122 S. MORENCI AVENUE
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City | MIO
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State | MI
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Zip | 48647-2508
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Country | US
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Telephone | 989-826-6830
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Fax | 989-826-6860
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Provider Business Mailing Address
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Address Line | 122 S. MORENCI AVENUE
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City | MIO
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State | MI
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Zip | 48647-2508
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Country | US
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Telephone | 989-826-6830
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Fax | 989-826-6860
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Authorized Official
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Title or Position | ALTERNATE ADMINISTRATOR
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Name | MR. JERRY PARKER
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Credential | PTA
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Telephone | 989-826-6830
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number |
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License Number State |
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