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General NPI Number Information
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NPI Number | 1417503715
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Entity Type | Organization
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Legal Business Name | PHYSIATRY AND REHABILITATION ASSOCIATES LLC
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Dates
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Enumeration Date | 08/13/2019
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Last Update Date | 08/18/2024
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Provider Practice Location Address
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Address Line | 113 BLARNEY DR
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City | COLUMBIA
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State | SC
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Zip | 29223-6244
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Country | US
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Telephone | 803-788-2225
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Fax | 803-788-2120
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Provider Business Mailing Address
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Address Line | 2700 S ROCHESTER RD STE A
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City | ROCHESTER HILLS
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State | MI
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Zip | 48307-4547
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Country | US
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Telephone | 248-212-0777
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Fax | 248-575-4144
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Authorized Official
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Title or Position | CEO
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Name | USAMA GABR
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Credential | MD
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Telephone | 513-309-8523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP3300X
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Taxonomy Name | Pain Clinic/Center
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License Number |
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License Number State |
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