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General NPI Number Information
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NPI Number | 1386690741
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Entity Type | Organization
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Legal Business Name | EXCELL REHAB INC
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Dates
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Enumeration Date | 05/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 29111 HARPER AVE
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City | ST CLAIR SHORES
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State | MI
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Zip | 48081
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Country | US
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Telephone | 586-772-2076
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Fax | 586-772-2076
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Provider Business Mailing Address
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Address Line | 29111 HARPER AVE
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City | ST CLAIR SHORES
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State | MI
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Zip | 48081
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Country | US
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Telephone | 586-772-2076
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Fax | 586-772-2076
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Authorized Official
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Title or Position | PRESIDENT
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Name | MADHUSAGER MAHINDRU
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Credential |
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Telephone | 586-772-2076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR0400X
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Taxonomy Name | Rehabilitation Clinic/Center
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License Number |
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License Number State |
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