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General NPI Number Information
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NPI Number | 1295996320
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Entity Type | Organization
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Legal Business Name | PHYSICAL REHABILITATION SERVICES PLLC
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Dates
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Enumeration Date | 06/20/2008
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 37620 FORD RD
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City | WESTLAND
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State | MI
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Zip | 48185-1924
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Country | US
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Telephone | 734-722-5400
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Fax | 734-722-5454
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Provider Business Mailing Address
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Address Line | 37620 FORD RD
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City | WESTLAND
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State | MI
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Zip | 48185-1924
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Country | US
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Telephone | 734-722-5400
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Fax | 734-722-5454
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | ROBERT M BEATTY
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Credential | P.T.
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Telephone | 734-722-5400
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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 | 5501010190
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License Number State | MI
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