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General NPI Number Information
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NPI Number | 1497001036
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Entity Type | Organization
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Legal Business Name | WELL-POINT REHAB LLC
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Dates
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Enumeration Date | 08/01/2012
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Last Update Date | 08/01/2012
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Provider Practice Location Address
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Address Line | 25321 5 MILE RD STE 2
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City | REDFORD
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State | MI
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Zip | 48239-3700
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Country | US
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Telephone | 313-387-4119
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Fax | 313-387-5148
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Provider Business Mailing Address
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Address Line | 25321 5 MILE RD STE 2
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City | REDFORD
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State | MI
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Zip | 48239-3700
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Country | US
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Telephone | 313-387-4119
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Fax | 313-387-5148
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. AHMED S KHAN
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Credential |
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Telephone | 313-387-5119
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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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