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General NPI Number Information
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NPI Number | 1417193558
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Entity Type | Organization
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Legal Business Name | STANDARD MEDICALS, INC
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Dates
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Enumeration Date | 12/19/2008
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Last Update Date | 12/19/2008
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Provider Practice Location Address
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Address Line | 33466 W 8 MILE RD STE 222
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-5208
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Country | US
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Telephone | 248-442-8100
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Fax |
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Provider Business Mailing Address
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Address Line | 33466 W 8 MILE RD STE 222
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City | FARMINGTON HILLS
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State | MI
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Zip | 48335-5208
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Country | US
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Telephone | 248-442-8100
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL DANESHVAR
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Credential | R.P.T.
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Telephone | 248-462-2020
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 5501003394
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License Number State | MI
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