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General NPI Number Information
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NPI Number | 1093872111
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Entity Type | Organization
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Legal Business Name | ST. JOHN HEALTH
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 7633 E. JEFFERSON SUITE 170
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City | DETROIT
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State | MI
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Zip | 48214
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Country | US
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Telephone | 313-499-4262
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Fax | 313-499-4878
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Provider Business Mailing Address
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Address Line | 7633 E. JEFFERSON SUITE 170
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City | DETROIT
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State | MI
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Zip | 48214
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Country | US
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Telephone | 313-499-4262
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Fax | 313-499-4878
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Authorized Official
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Title or Position | DIRECTOR OF COMPREHENSIVE REHAB
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Name | MRS. SHEILA NORWOOD
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Credential |
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Telephone | 313-499-4671
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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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