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General NPI Number Information
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NPI Number | 1114342433
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Entity Type | Organization
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Legal Business Name | MICHIGAN REHAB SERVICES PROVIDER, INC.
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Dates
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Enumeration Date | 02/24/2014
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Last Update Date | 02/24/2014
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Provider Practice Location Address
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Address Line | 1681 E AUBURN RD SUITE C
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5583
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Country | US
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Telephone | 586-797-9775
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Fax | 586-797-9750
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Provider Business Mailing Address
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Address Line | 1681 E AUBURN RD SUITE C
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-5583
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Country | US
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Telephone | 586-797-9775
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Fax |
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Authorized Official
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Title or Position | DIRECTOR OF BUSINESS OPERATIONS
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Name | NILESHKUMAR PATEL
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Credential | PT
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Telephone | 586-797-9775
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501011761
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License Number State | MI
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