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General NPI Number Information
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NPI Number | 1407232739
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Entity Type | Organization
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Legal Business Name | TRI-CARE PHYSICAL THERAPY LLC
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Dates
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Enumeration Date | 08/10/2015
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Last Update Date | 11/09/2022
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Provider Practice Location Address
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Address Line | 24100 W. WARREN AVE
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127
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Country | US
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Telephone | 313-434-6000
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Fax | 313-427-8166
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Provider Business Mailing Address
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Address Line | 24100 W. WARREN AVE
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127
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Country | US
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Telephone | 313-434-6000
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Fax | 313-427-8166
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Authorized Official
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Title or Position | OWNER
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Name | ADEEB NAGIB SOBH
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Credential |
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Telephone | 313-334-1116
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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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