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General NPI Number Information
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NPI Number | 1205936275
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Entity Type | Organization
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Legal Business Name | REHABILITATION PROFESSIONALS OF MICHIGAN, PLC
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 08/23/2007
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Provider Practice Location Address
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Address Line | 22632 RIDGEWAY ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1476
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Country | US
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Telephone | 586-945-4658
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Fax | 586-777-9232
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Provider Business Mailing Address
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Address Line | 22632 RIDGEWAY ST
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City | SAINT CLAIR SHORES
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State | MI
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Zip | 48080-1476
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Country | US
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Telephone | 586-945-4658
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Fax | 586-777-9232
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Authorized Official
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Title or Position | PRESIDENT / OWNER
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Name | MRS. ANGELA EATON
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Credential | MD
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Telephone | 586-945-4658
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State |
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