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General NPI Number Information
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NPI Number | 1073108643
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Entity Type | Organization
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Legal Business Name | PAIN AND SPINE RECOVERY PLLC
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Dates
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Enumeration Date | 03/05/2021
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Last Update Date | 03/05/2021
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Provider Practice Location Address
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Address Line | 8560 N SILVERY LN
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-4515
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Country | US
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Telephone | 248-525-8697
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Fax |
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Provider Business Mailing Address
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Address Line | 27644 HARTWICK CIR
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City | NOVI
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State | MI
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Zip | 48374-4002
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Country | US
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Telephone | 248-525-8697
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | ABID AGHA
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Credential | MD
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Telephone | 248-525-8697
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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