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General NPI Number Information
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NPI Number | 1407710999
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Entity Type | Organization
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Legal Business Name | EVOLVE REHAB PLLC
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Dates
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Enumeration Date | 12/10/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 6256 N TELEGRAPH RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3223
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Country | US
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Telephone | 313-483-6002
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Fax |
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Provider Business Mailing Address
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Address Line | 6256 N TELEGRAPH RD
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City | DEARBORN HEIGHTS
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State | MI
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Zip | 48127-3223
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | MOHAMED RAYCHOUNI
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Credential | DC
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Telephone | 313-483-6002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 2083P0011X
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Taxonomy Name | Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number |
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License Number State |
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