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General NPI Number Information
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NPI Number | 1366689671
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Entity Type | Organization
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Legal Business Name | NEWDIMENSIONS REHAB
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Dates
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Enumeration Date | 01/08/2009
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Last Update Date | 01/08/2009
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Provider Practice Location Address
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Address Line | 19460 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48223-1200
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Country | US
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Telephone | 313-318-3749
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Fax |
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Provider Business Mailing Address
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Address Line | 19460 GRAND RIVER AVE
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City | DETROIT
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State | MI
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Zip | 48223-1200
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Country | US
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Telephone | 313-318-3749
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | ISHTIAQ AHMAD
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Credential |
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Telephone | 313-318-3749
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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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