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General NPI Number Information
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NPI Number | 1457356453
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Entity Type | Organization
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Legal Business Name | PRIME REHAB AND PHYSICAL THERAPY INC
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Dates
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Enumeration Date | 06/16/2005
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Last Update Date | 03/07/2012
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Provider Practice Location Address
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Address Line | 2900 S FORT ST STE 3
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City | DETROIT
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State | MI
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Zip | 48217-1061
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Country | US
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Telephone | 313-388-0156
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Fax | 313-388-0593
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Provider Business Mailing Address
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Address Line | 7140 W FORT ST STE 4
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City | DETROIT
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State | MI
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Zip | 48209-2917
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Country | US
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Telephone | 313-357-3079
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Fax | 313-388-0593
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | DR. MUHAMMAD SADIQ
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Credential |
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Telephone | 313-357-3079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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